On one hand structural cardiac anomalies and arrhythmias such as atrial fibrillation can give rise to thrombi that are dislodged as emboli to the brain and cause stroke. On the other hand acute emotional stress or cerebral events can cause acute cardiac dysfunction with left ventricular failure in the absence of cardiac causes. The extreme variant of stress cardiomyopathy is known as Takotsubo cardiomyopathy. Patients are presenting with chest pain, electrocardiographic changes similar to acute myocardial infarction with ST-segment elevation, T-wave inversion, or QT prolongation, and elevated cardiac biomarkers such as CK and troponin. When coronary angiography is performed coronary arteries are normal, but the left ventricle shows mostly apical and midventricular dyskinesia and apical ballooning or rarely basal akinesia and apical hyperkinesia. The exact pathogenesis is unknown. Presumably high catecholamine levels resulting from the extreme emotional stress or acute cerebral events cause severe peripheral vasospasms resulting in myocardial dysfunction.