A 63-year-old woman presented with a sudden exacerbation of chronic obstructive lung disease and elevated levels of cardiac troponin T (0.5 ng/mL). The electrocardiogram exhibited sinus tachycardia, P-pulmonale, and diffuse T-wave inversion. The echocardiogram displayed markedly impaired left ventricular function. In view of these diagnostic findings and ongoing dyspnoea, the patient was referred for emergency cardiac catheterization. Left ventricular angiography demonstrated a depressed ventricular function with an unusual pattern of wall motion abnormalities, characterized by a circular mid-ventricular balloon-like dyskinesis and marked apical …