Broken Heart! Surprised to Know Why!

A 70-year-old female attended the emergency department with cardiac sounding chest pain, cough, new concerning ECG changes and recent history of long flight. Her cardiac enzymes were elevated raising the suspicion of Acute Coronary syndrome. She was taken for urgent percutaneous coronary intervention which did not reveal any significant obstructive coronary artery disease however, ventriculogram revealed severe left ventricular systolic dysfunction (LVSD) with typical apical akinesis resembling takatsubo. A transthoracic echocardiogram confirmed severely reduced left ventricular ejection fraction. In addition, she was also treated for pneumonia which was the possible trigger of the event.