Electrocardiographic differences between takotsubo and acute anterior myocardial infarction

Takotsubo syndrome (TS) simulates and is part of the differential diagnosis of acute coronary syndromes (ACS). In the case of acute anterior myocardial infarction with ST segment elevation (STEMIa), electrocardiographic (ECG) differences have been described in Asian population. The objective of the present study is to describe the specific differences in the ECG that allows to suspect TS in the Western population. Methods: In a retrospective fashion the ECG of TS have been analyzed and compared to the ECG of patients without previous coronary artery disease presenting with STEMIa. The ECG variables were hand measured. Results: ECG from 13 TS and 10 STEMIa were compared. There were more leads with ST segment elevation (STE) in STEMIa than with TS, 6.3± 1.8 vs. 4.2± 2.3 (p=0.042), respectively. In relation to the ST segment depression (STD), it was more frequent in STEMIa, and with a bigger depression in DIII in this group of patients. Conclusions: This research shows ECG differences in Takotsubo and acute anterior myocardial infarction with ST segment elevation (STEMIa).