Slide 1: What do lightning, wasabi, and tooth extractions have in common?

Slide 2: All have been triggers of Takotsubo cardiomyopathy!

Slide 3: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, can present like acute coronary syndrome and develop after a variety of physical and emotional triggers. 30% of the time a trigger is never identified.

Slide 4: Classically, the disease was associated with the death of a loved one. However, there have been reports of cases occurring after triggers including lightning, surprise party, tooth extraction, and adultery.

In one extraordinary case report, a woman developed Takotsubo cardiomyopathy after mistaking a large amount of wasabi for an avocado!


  • Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, Wu KC, Rade JJ, Bivalacqua TJ, Champion HC. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005 Feb 10;352(6):539-48. PMID 15703419.
  • Imnadze G, Metreveli L, Franz N, Thale J. Case of Takotsubo cardiomyopathy after tooth extraction – Unusual trigger of a rare syndrome. J Cardiol Cases. 2014 Jul 17;10(4):129-131. PMID 30534223.
  • Bhavanadhar P, Palepu JK, Sangar B. Takotsubo cardiomyopathy following lightning strike in a young woman – a rare care report. IHJ Cardiovascular Case Reports (CVCR) 2018; 2(3):155-159. Link.
  • Finkel-Oron A, Olchowski J, Jotkowitz A, Barski L. Takotsubo cardiomyopathy triggered by wasabi consumption: can sushi break your heart? BMJ Case Rep. 2019 Sep 20;12(9):e230065. PMID 31540920.

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