Case Report: A 72 year old male underwent a dobutamine stress echocardiography (DSE) for assessment of atypical chest pain and dyspnoea. Past medical history includedchronic obstructive pulmonary disease, hypertension, type 2 diabetes mellitus and smoking history. The baseline electrocardiogram (ECG) and vital signs were within normal limits. The resting echocardiogram showed normal valve function, left ventricular size, ventricular wall thickness and systolic function with an ejection fraction of 65%. Dobutamine was infused according to the protocol 10 mcg/kg/min increasing in 3 minute intervals to achieve a maximum heart rate of 148 beats per minute at 50 mcg/ kg/min. During stress, he experienced minor “indigestion”symptoms without distinct ECG changes. Imaging at 70% of peak heart rate and 85% of peak heart rate showed no inducible wall motion abnormalities. 5 minutes into recovery phase, he became hypotensive and developed progressive chest pain associated with ST-elevation of 4mm in antero-lateral and inferior leads. The recovery echocardiogram showed mid and distal septal akinesis, a dyskinetic apex, vigorous basal septal and lateral wall motion. Coronary angiogram revealed normal coronary arteries with left ventricular systolic dysfunction. Troponin I peaked at 2.3μg/L and a diagnosis of dobutamine-induced takotsubo cardiomyopathy (TC). Patient was discharged 48 hours later. A transthoracic echocardiogram 3 months post-discharge revealed an ejection fraction of 71% and normal left ventricular function and patient denied chest pain or heart failure symptoms. Conclusion: This is only the second case of a dobutamine-induced stress cardiomyopathy to have occurred in an elderly male and the fi rst during the non-stress phase. TC is uncommon adverse effect of DSE in female patients but rarely documented in males. May refl ect sex differences in the myocardial threshold to resist catecholamine induced TC and advise caution when administering dobutamine protocols.