To the Editor: We report a case series of 4 patients with Takotsubo cardiomyopathy (TC) in the setting of myasthenic crisis (see Table 1, Supplemental Digital Content 1, http://links.lww.com/JCND/A36). Takotsubo cardiomyopathy is an acute, reversible cardiomyopathy that can mimic acute coronary syndrome and is believed to be triggered by acute stress due to emotional or physical factors.1 Takotsubo cardiomyopathy has been reported in myasthenic crisis (see Table 2, Supplemental Digital Content 2, http://links.lww.com/JCND/A37) but has been more commonly described in patients who are critically ill due to other acute neurologic conditions, especially subarachnoid hemorrhage and seizures.2,3