A Whodunnit: Anterior ST-Elevation Myocardial Infarction in a Patient Found to Have Apparent Takotsubo Cardiomyopathy, Left Anterior Descending Artery Disease, and Myocardial Bridging

We present a case of a 52-year-old male with no known past medical history who presented to an outside hospital with acute chest pain. Initial workup revealed anteroseptal ST-elevation myocardial infarction (STEMI) for which the patient was transferred to our facility for emergent percutaneous coronary intervention (PCI). However, the patient's hospital course revealed numerous confounding pathologies that can also present as STEMI, including transthoracic echocardiogram (TTE) abnormalities consistent with takotsubo cardiomyopathy (TCM) as well as myocardial bridging presenting as post-PCI STEMI in the setting of nitroglycerin use. The purpose of this case report is to discuss non-acute coronary syndrome causes of STEMI, specifically TCM and myocardial bridging, in a patient who presented with acute onset chest pain and ECG changes.