eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-07-03 8 10 350 357 10.12691/ajmcr-8-10-8 AJMCR20208108 article Pramod Theetha Kariyanna 1 Harshith Priyan Chandrakumar 1 Apoorva Jayarangaiah 2 Abdullah Khan 3 Volodymyr Vulkanov 4 Michael Ashamalla 4 Moro O. Salifu 4 Samy I. McFarlane smcfarlane@downstate.edu 4 Department of Internal Medicine, State University of New York- Downstate Medical Center, Brooklyn, New York, U.S.A-11203 Division of Hematology and Oncology, Department of Internal Medicine, Albert Einstein College of medicine/Jacobi Medical Center, Bronx, N.Y., U.S.A 10461 Divisions of Cardiology, Department of Internal Medicine, Brookdale University Hospital and Research Center, Brooklyn, New York, U.S.A-11212 Neurology, Department of Internal Medicine, Brookdale University Hospital and Research Canter, Brooklyn, New York, U.S.A-11212 COVID-19 is a pandemic that started in Wuhan city, Hubei province in China in December 2019 and is associated with high morbidity and mortality. It is characterized by a heightened inflammatory and prothrombotic state that are known to cause various cardiovascular manifestations such as thromboembolism, acute coronary syndrome and stroke. We here present a 72-year-old woman with multiple cardiovascular risk factors and COVI 19 pneumonia who presented with acute ischemic stroke. She was also noted to have ST segment elevation myocardial infarction (STEMI) on the electrocardiogram however the imaging and clinical presentation was consistent with apical takotsubo cardiomyopathy. We here discuss the various pathophysiologic mechanisms by which COVID-19 can result in acute stroke. The patient likely developed takotsubo cardiomyopathy because of stroke and acute COVID-19 induced sympathetic stimulation and catecholamine surge. To the best of our knowledge this is the first case of apical variant of takotsubo cardiomyopathy in a COVID-19 report. http://pubs.sciepub.com/ajmcr/8/10/8/ajmcr-8-10-8.pdf COVID-19 takotsubo cardiomyopathy stress cardiomyopathy STEMI stroke cerebrovascular accident