Bedside echocardiography plays an important role in the first-line diagnosis of Takotsubo cardiomyopathy (TC). Several classic imaging features could aid in the differential diagnosis in patients who have manifestation similar to that of acute coronary syndrome and potentially help in the risk stratification and management, including the decision to use coronary angiography.1,2 Right ventricular (RV) involvement in TC has been previously identified.3,4 However, these abnormal imaging features have never been well characterized and analyzed.