Relevance and purpose: TC is a reversible focal myocytolysis, whereas MI is an irreversible damage of cardiomyocytes. Although TC affects 1-2% of people with cardiac disorders, our purpose is to be able to clinically determine whether a patient is experiencing a myocardial infarction or an attack of TC.

Methods and materials: Based on different literary materials and recently reviewed International Takotsubo Registry, we were able to distinguish the clinical characteristics of TC and MI recently reviewed in the International Takotsubo Registry.

Results: In acute setting TC and MI has a similar clinical appearance of retrosternal chest pain, dyspnea and/ or syncope. The pain in MI usually radiates to left arm, back, and jaw. Whereas in TC, pain is only retrosternal and precipitated by emotional or physical trigger. In laboratory signs, troponin is increased in both cases with a modest increase in TC, and severe increase in MI. On ECG in TC ST-elevation occurs in anterior leads where as in MI it can occur in any leads. On coronary angiography, both TC and MI can present with coronary disease. TC does not affect the left anterior descending artery, and has mild to moderate coronary atherosclerosis. MI presents with obstructive coronary disease or ruptured atherosclerotic plaque. On echocardiography in TC you can see apical ballooning and or/ Transient hypo kinesis, dyskinesia/akinesia. In MI you can see regional wall abnormalities.

Conclusion: In acute settings, it is hard to differentiate between TC and MI without measuring cardiac markers, ECG, Coronary angiography and Echocardiography.