Abstract
BACKGROUND: Takotsubo cardiomyopathy is a transient left ventricular dysfunction mimicking acute coronary syndrome, typically occurring in postmenopausal women. Its association with acute pericarditis is rare, raising questions about causality and sequence. CASE SUMMARY: A 64-year-old woman presented with chest pain, elevated troponin, and echocardiographic findings consistent with Takotsubo cardiomyopathy. Coronary angiography showed no obstructive disease. Hours later, the patient developed pleuritic chest pain, and cardiac magnetic resonance confirmed pericardial involvement. She was treated with nonsteroidal anti-inflammatory drugs, colchicine, beta blocker, and supportive care, with full recovery of ventricular function at discharge. DISCUSSION: Reported cases of concomitant Takotsubo cardiomyopathy and pericarditis are scarce. Pericarditis may arise as a complication of TC via inflammatory spread or, conversely, act as a trigger through stress-induced catecholamine release. Cardiac magnetic resonance is crucial to differentiate Takotsubo cardiomyopathy from myocarditis. TAKE-HOME MESSAGE: This case illustrates the rare Takotsubo cardiomyopathy-pericarditis association and emphasizes the diagnostic value of advanced imaging for accurate management.