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Stress-induced cardiomyopathy (SIC) is an increasingly recognized disease entity and is accepted as a unique form of reversible cardiomyopathy. Typical apical ballooning precipitated by emotional stress with clinical features mimicking acute coronary syndrome and rapid recovery was a hallmark of SIC. Along with cumulative experiences, new features are well appreciated. These include atypical ballooning patterns (mid-ventricular and basal ballooning), contribution of physical stressors (acute medical illnesses and routine diagnostic and therapeutic procedures including surgery) to the development of SIC, and development of serious complications such as right ventricular dysfunction, thrombus formation, and left ventricular outflow tract obstruction with significant mortality rate and occasional recurrence, representing diverse clinical spectrum of SIC. Although the exact mechanism and standard treatment of SIC has not been established, physicians’ vigilance is needed for prompt diagnosis and adequate treatment for this potentially fatal disorder. Echocardiography can play a role as an easy and noninvasive imaging modality.