Tako-Tsubo cardiomyopathy (TK) is an acutely appearing myocardial disease leading to impaired cardiac function, which can barely be distinguished clinically from an acute myocardial infarction. It occurs mainly in postmenopausal women and usually has a good prognosis. The pathophysiology of TK still remains to be elucidated but the favoured hypothesis is myocardial damage induced by catecholamine excess. Various acute diseases, emotional stress, surgical procedures and anaesthesia have been described as possible causes for TK. Little is known about the optimal therapy, however, there might be potential differences in the therapy of TK compared to contemporary therapy algorithms for heart failure. Knowledge of TK as a differential diagnosis for acute myocardial infarction is necessary to avoid incorrect treatment.