The diagnosis of Takotsubo cardiomyopathy (TC) must be considered in all patients who develop transient left ventricular apical (or mid ventricular) ballooning in the absence of obstructive coronary artery disease (CAD). Although the prevalence of TC remains unknown, approximately 2% of all patients presenting with a presumed diagnosis of ST elevation myocardial infarction have been found to have this syndrome. TC usually occurs in the setting of physical or emotional stress associated with excessive sympathetic stimulation and catecholamine release. A literature review and illustrative case report are provided. © 2007 Bentham Science Publishers Ltd.