Do pathologists agree on how to diagnose takotsubo cardiomyopathy?

Excerpt

I read with great interest the report by Indorato et al. [1] regarding takotsubo transient cardiomyopathy (TTC). The authors described a case of sudden death in which the autopsy findings featured apical rupture of the myocardium. In reviewing the details of this case, I began to wonder whether the criteria for diagnosing TTC are well established in the field of pathology. In particular, the authors did not have a pre-mortem electrocardiogram, evidence of apical ballooning (pre- or post-mortem), or an elevation in catecholamine blood levels (the purported etiologic factor) on which to base their diagnosis. Obviously, disappearance of segmental akinesia is the main feature that was absent. …