The ECG in stress cardiomyopathy versus acute coronary syndrome

I've blogged this topic a couple of times before. Though the two conditions are superficially similar clinically and electrocardiographically they are completely different pathologically. It makes sense that there would be distinctions evident on close examination. Here is another paper on the electrocariographic differences. From the paper:

T inversion and ST elevation mainly appear in precordial leads and more rarely in limb leads. The duration of ST elevation is short, whereas that of T inversion is long. In some cases, T inversion appears for a while after ST elevation begins, disappears, and then begins to appear again. Differences between these two forms require prospective studies with more patients.

It was also pointed out in the paper that patients with stress cardiomyopathy did not exhibit reciprocal ST depressions whereas sinus tachycardia was common. Note that sinus tachycardia is not generally a manifestation of ACS per se and when present is an ominous sign, signifying acute heart failure or cardiogenic shock.