Abstract

Takotsubo cardiomyopathy is a cardiac condition often associated with a favorable prognosis. However, its acute phase can be complicated by severe adverse events. We describe a 70-year-old woman who presented with chest pain and dyspnea after returning from a trip abroad. Initial evaluation revealed ST-segment elevation on electrocardiogram and a left ventricular apical thrombus on echocardiography. Coronary angiography ruled out significant coronary artery disease, leading to a diagnosis of Takotsubo cardiomyopathy. Despite anticoagulation therapy, the patient suffered a transient ischemic attack, and ST- elevation myocardial infarction due to thrombotic occlusion of the left anterior descending artery. Treatment included reperfusion therapy and guideline-directed medical therapy. This case highlights the potential for severe thromboembolic complications in Takotsubo cardiomyopathy, underscoring the importance of close monitoring and early anticoagulation in patients with intraventricular thrombus.