Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said " Nothing too exciting. "

This article fails to specify whether it was troponin I or T, but I contacted the institution and they used exclusively troponin I during that time period.Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al. The impact of ST-segment elevation on the prognosis of patients with Takotsubo cardiomyopathy. J Electrocardiol [Internet] 2022;Available from: http://dx.doi.org/10.1016/j.jelectrocard.2022.09.009Cardiology opinion: Takotsubo Cardiomyopathy (EF 30-35%)V Fib Cardiac arrestProlonged QTCNSTEMI (Smith comment: is it NSTEMI or is it Takotsubo?  -- these are entirely different)Moderate single-vessel CAD.Then they did an MRI:Patient underwent cardiac MRI on 10/4 that showed mildly reduced BiV systolic function. LVEF 51% and RVEF 49% with severe hypokinesis of distal septal, distal anterior, apical and distal inferior segments.  Noted increased myocardial and pericardial fluid content. Delayed enhancement reveals small, subendocardial scar in the distal septal, apical and distal inferior segments consistent with scar in the LAD distribution. Findings consistent with infarct in LAD distribution (likely recent). Just to add more evidence, here is the post reperfusion ECG:There is terminal T-wave inversion (identical to Wellens ' Pattern A).Although one sees diffuse symmetric T-wave inversion develop in takotsubo, with a long QT, one does NOT see Wellens ' pattern A in takotsubo.I could have told you this (and did tell you this...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs