Background: Takotsubo cardiomyopathy is a temporary left ventricular disorder which mimics the symptoms of an acute coronary incident. However, Cardiac catheterization often indicates normal coronary vessels. Patients are often postmenopausal women or individuals with acute affective disorders and distress. In this paper, a case of Takotsubo cardiomyopathy associated with emotional distress was explored. Case summary: A 46 year old woman presented to the hospital with chest pain and dyspnea. The patient was week, pale and lethargic with a severe pain on the left side of the chest. Laboratory results indicated positive TPi enzyme. In ECG, Q wave in V1-V6 lead and reverse T wave in I, AVL and V1-V6 l leads were evident. Echocardiography findings indicated apical akinesis and EF of 35%. Conclusion: Since Takotsubo in premenopausal women is less prevalent and early diagnosis is difficult, therefore, considering clinical symptoms and patients history at admission are helpful.