Medical Mnemonics

Takotsubo Cardiomyopathy Mnemonic – “BROKEN Heart”

May 31, 2025

Let me paint a picture: You’re in the Emergency Department at 2 a.m., flipping through troponins and chasing ECGs like a caffeine-fueled cardiophile… and then, there it is — ST elevation, apical ballooning on echo, coronaries clean as a whistle. Your inner Sherlock mutters: “It’s not a heart attack… it’s heartbreak.” 💔

Welcome to the emotionally dramatic world of Takotsubo Cardiomyopathy — a condition that looks exactly like an MI, behaves like an MI, but isn’t an MI. Also known as Stress-Induced Cardiomyopathy, it’s what I call the real-life plot twist of the CCU.

But before we dive into this mnemonic, let’s first understand what it really is:

Table of Contents

💡 What Is Takotsubo Cardiomyopathy?

A transient, reversible LV dysfunction usually triggered by severe emotional or physical stress — hence the nickname “Broken Heart Syndrome.”

Named after a Japanese octopus trap (:D yes, really), due to the ballooned-out shape of the LV on echo.

Takotsubo Cardiomyopathy Mnemonic – “BROKEN”

Letter	Represents	Explanation
B	Ballooning (Apical)	Classic echo finding – apical ballooning, mimicking anterior MI.
R	Reversible	LV dysfunction typically recovers in days to weeks.
O	Often Post-Stress	Emotional trauma, surgery, illness — the trigger is usually dramatic. 😩
K	Klean Coronaries	Angiography shows no obstructive coronary artery disease.
E	ECG Mimics STEMI	ST elevation, T wave inversion, QT prolongation — but no infarct.
N	Non-Ischemic Pattern on MRI	Cardiac MRI: no late gadolinium enhancement (helps differentiate from MI).

🩺 Clinical Pearls from the CCU (Quetta Chronicles)

I still remember a middle-aged lady we admitted during Eid, classic story — sudden chest pain after hearing her son was in an accident (he turned out fine). Troponins were mildly up, ECG screamed STEMI, echo looked like the heart was auditioning for a balloon animal contest. But angio? Clean.

Takotsubo. We treated supportively and watched her LV recover like a champ within 2 weeks.

Moral of the story: Always suspect Takotsubo when ECG is loud but angio is innocent.