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More recently there has been a shift towards thinking of TC as a \u2018microvascular acute coronary syndrome\u2019. Our case is of an 82-year-old woman who presented with TC mimicking acute anterior ST elevation myocardial infarction in the context of sepsis. Slow flow noted in the left anterior descending artery prompted us to perform coronary physiology. Her fractional flow reserve was 0.91, with an index of myocardial resistance of 117 and a coronary flow reserve of 1.6. In combination these results are indicative of microvascular coronary dysfunction in the absence of significant epicardial stenosis.<\/jats:p>","DOI":"10.1136\/bcr-2019-229618","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T07:36:19Z","timestamp":1567064179000},"page":"e229618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["\u2018Acute micro-coronary syndrome\u2019: detailed coronary physiology in a patient with Takotsubo cardiomyopathy"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4067-8249","authenticated-orcid":false,"given":"Andrew J","family":"Morrow","sequence":"first","affiliation":[{"name":"Cardiology, Golden Jubilee National Hospital, Clydebank, UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, 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