A "bad" case of Tako-Tsubo syndrome.

The prognosis of Tako-Tsubo syndrome (TTS) is believed to be favorable. In most of the cases, there is a complete recovery of left ventricular (LV) function and of symptoms, but previous cases have been described with low-output syndrome, deaths within the first 24 h from acute heart failure, and some deaths due to LV free wall rupture. We describe a case of a patient with TTS who died after right ventricular (RV) free wall rupture. Furthermore, this report suggests that cardiac magnetic resonance imaging with echocardiography might be a useful integrated imaging diagnostic tool for the diagnosis of TTS, ruling out acute coronary syndrome.