Myocardial infarction with ST-segment elevation in old patient with history of takotsubo syndrome

Elderly patients, especially women often present atypical symptoms and chest pain may be wrong diagnosed. We present a patient who was admitted to the hospital two times because of the similar symptoms but diagnosis was completely different. Most researchers believe that significant changes in the coronary arteries exclude the diagnosis of takotsubo syndrome (TTS). However, some reports admit the possibility of coexistence of TTS and coronary artery disease. Presented patient had not had any changes in coronary arteries until four years later when she had myocardial infarction associated with right coronary artery narrowing, despite the fact that the risk factors of coronary heart disease were closely monitored. It is very important to maintain a high index of suspicion for acute myocardial infarction in elderly patients even if symptoms and past medical history suggest alternative diagnosis.