Abstract
Since its first description in 1990, Takotsubo cardiomyopathy (TC) has continued to puzzle physicians and scientists alike as the mechanisms behind the characteristic unique left ventricular dysfunction that marks the condition and its relation to the intense emotional and physiological stressors that usually precede it have remained not fully understood. Since then, several different variants of the condition have been described that do not conform to the conventional narrative of a post-menopausal disease that only affects women of a certain age and is triggered by a preceding event. Of these variants, atypical Takotsubo, which does not assume the typical characteristic apical ballooning that marks the condition has been linked with a younger age group and a more neurological trigger. A strong guideline-based clinical suspicion and an astute knowledge of its clinical, laboratory, and different morphological presentations are often needed to differentiate the case from acute coronary syndromes, which it so closely resembles. This case illustrates an atypical presentation of atypical TC in an otherwise healthy woman and how a guideline-based approach can be utilized to identify and manage the condition while discussing the most recent theories addressing TC.