Supra‐Hisian Conduction Block as an Unusual Presenting Feature of Takotsubo Cardiomyopathy

Background Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). Case report A 66‐year‐old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra‐Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation. At 1‐month follow‐up, she had normal ventricular function and no AV block. Conclusion Delayed recovery of AV conduction is possible in TC, thus implying to wait for a longer period before implanting a pacemaker.