Stress cardiomyopathy or Takotsubo syndrome are variants of an acute and reversible form of compromised cardiac function, characterised by an acute onset, usually related to a stressful emotional or physical event, accompanied by chest pain or dyspnoea, and signs of myocardial injury (signs or symptoms compatible with heart failure, myocarditis, anomalies in the electrocardiogram, and an increase in biomarkers, such as troponin and natriuretic peptides). These make stress cardiomyopathy indistinguishable from the usual acute coronary syndrome (ACS) in any variation or acute heart failure syndromes (AHFS). Its diagnosis requires high clinical suspicion and the rational use of imaging aids, known as the multimodal approach. In this case transthoracic cardiac ultrasound is the most used tool for the initial approach and identification of the typical pattern of apical and transient compromise of this condition. However, it needs to be combined with other diagnostic methods in order to complete the diagnostic criteria, to carry out a haemodynamic follow-up, and to detect complications. They are also required to evaluate recovery during out-patient follow-up, becoming a great diagnostic and therapeutic challenge.