Introduction: Stress induced apical ballooning syndrome (Takotsubo cardiomyopathy) is a disorder with transient left ventricle dysfunction, ECG changes, release of cardiospecific markers which can mimic myocardial infarction in presence of unaffected coronary arteries.
Case report: A 61-year-old woman after dual chamber pacemaker replacement complained of acute chest pain, shortness of breath suggesting acute myocardial ischemia. Performed diagnostic procedures (echocardiography, coronary angiography, left ventriculography) revealed severe impairment of left ventricle contractility with its apical balloon-like dilation. Coronary arteries were not affected. Cardiospecific markers were increased significantly. After treatment with beta-blockers, ACEIs, anticoagulants and diuretics the clinical and echocardiographic picture normalized at discharge. Cardiac markers normalized after one month of observation. This case represents a rare event when apical ballooning syndrome is associated with pacemaker replacement.