<prompt> Myocardial stunning pattern in ECG, which mimics myocardial infarction?Takotsubo cardiomyopathyRestrictive cardiomyopathyBrugada SyndromePericardial effusion  <response>: A Takotsubo cardiomyopathy?Myocardial Stunning is a condition where certain segments of myocardium corresponding to area of major coronary occlusion shows forms of contractile abnormality.oSegmental dysfunction persisting for a variable period of time, about 2 weeks, even after ischemia has been relieved by for Instance Angioplasty or Coronary Artery Bypass Surgery.oTakotsubo cardiomyopathy or Takotsubo syndrome, is a temporary condition where the heart muscle becomes suddenly weakened or stunned.oSymptoms of Takotsubo stress-related cardiomyopathy often start abruptly with chest pain shortness of breath.oThis cardiomyopathy, is triggered by an emotionally or physically stressful event may mimic acute MI.oAssociated ECG abnormalities: ST-segment elevation elevated biomarkers of myocardial injury.Other Options?Restrictive Cardiomyopathy:-It is dominated by abnormal diastolic function, often with mildly decreased contractility ejection fraction usually 30-50.-Seen in Amyloidosis, sarcoidosis, hemochromatosis etc.,-Ventricles become rigid lack the flexibility to expand during diastole.-SOB, fatigue, palpitations syncope.-Other Common Findings: Atrial fibrilation, conduction delays.-ECG shows Low voltage, non-specific ST-T wave abnormalities various arrhythmias.?Brugada byndrome:-ECG shows 0.2mV of ST-segment elevation with coved ST segment negative T wave in more than one anterior precordial lead V1 -V3 and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural heart disease.-Cardiac arrest may occur during sleep or be provoked by febrile illness.-Males are more commonly affected than females.-Quinidine used successfully to suppress frequent episodes of VT?Pericardial Effusion:oClassical triad of findings for pericardial effusionowith cardiac tamponade:-Sinus tachycardia,-Low QRS voltage,-Electrical alternans Best seen in V3 V4 