A case report of Kounis syndrome presenting with coronary angina pectoris and coronary microcirculatory disturbance, resulting in takotsubo cardiomyopathy-like changes

There are few reports of an invasive evaluation in the subacute phase of Takotsubo cardiomyopathy-like clinical presentation. We report a case of takotsubo-like wall motion abnormality due to CSA and CMD in a patient with Kounis syndrome. Simultaneous binuclear myocardial scintigraphy, assessment of the coronary microcirculation, and ACh stress test were useful in the diagnosis, and the coexistence of CSA and CMD suggested her clinical images similar to takotsubo cardiomyopathy.