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Transient Left Ventricular Apical Ballooning

2003; Lippincott Williams & Wilkins; Volume: 108; Issue: 16 Linguagem: Inglês

10.1161/01.cir.0000079313.93444.f1

1524-4539

Christian Witzke, Harry C. Lowe, Howard M. Waldman, Igor F. Palacios,

Cardiac Imaging and Diagnostics

HomeCirculationVol. 108, No. 16Transient Left Ventricular Apical Ballooning Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBTransient Left Ventricular Apical Ballooning C. Witzke, H.C. Lowe, H. Waldman and I.F. Palacios C. WitzkeC. Witzke From the Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass. , H.C. LoweH.C. Lowe From the Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass. , H. WaldmanH. Waldman From the Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass. and I.F. PalaciosI.F. Palacios From the Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Mass. Originally published21 Oct 2003https://doi.org/10.1161/01.CIR.0000079313.93444.F1Circulation. 2003;108:2014A 69-year-old woman presented with acute onset of chest pain and diffuse ST-segment elevation suggesting ischemia (Figure 1). The creatine phosphokinase–MB was elevated, and in view of ongoing chest discomfort, she was referred for urgent cardiac catheterization. Download figureDownload PowerPointFigure 1. Twelve-lead ECG showing normal sinus rhythm and extensive anterior wall ST-segmental abnormalities.Coronary angiography revealed normal coronary arteries. Ventriculography demonstrated a markedly abnormal left ventricle, with apical ballooning in systole (Figure 2A and 2B). Overall left ventricular function was depressed, with an ejection fraction of 33% and severe mitral regurgitation (Figure 2A and 2B). A midcavity left ventricle gradient of 25 mm Hg was also noted. With supportive therapy, spontaneous clinical recovery occurred within 1 week and left ventricular function returned to normal on follow-up echocardiography at 40 days. Download figureDownload PowerPointFigure 2. End-diastolic (A) and end-systolic (B) frame of left ventriculography showing anterolateral, anteroapical, and apical inferior wall dyskinesis with hypercontractile base (left ventricular apical ballooning).The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke's Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.FootnotesCorrespondence to Dr I.F. Palacios, Director of Cardiac Catheterization Laboratories, Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Bullfinch 105, Boston, MA 02144-2696. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Jalloul Y and Refaat M (2020) Left ventricular apical thinning, Journal of Cardiovascular Electrophysiology, 10.1111/jce.14385, 31:4, (921-923), Online publication date: 1-Apr-2020. Yu G, Jun S and Shin D (2016) Associations of VCAM-1 gene polymorphisms with obesity and inflammation markers, Inflammation Research, 10.1007/s00011-016-1006-2, 66:3, (217-225), Online publication date: 1-Mar-2017. Jain M, Upadaya S and Zarich S (2013) Serial Evaluation of Microcirculatory Dysfunction in Patients With Takotsubo Cardiomyopathy by Myocardial Contrast Echocardiography, Clinical Cardiology, 10.1002/clc.22154, 36:9, (531-534), Online publication date: 1-Sep-2013. Samardhi H, Raffel O, Savage M, Sirisena T, Bett N, Pincus M, Small A and Walters D (2012) Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up, Internal Medicine Journal, 10.1111/j.1445-5994.2011.02474.x, 42:1, (35-42), Online publication date: 1-Jan-2012. Cao Y, Zhang M, Li X, Xie P and Cronin L (2009) Reversible transient apical ballooning syndrome with coronary lesions, Journal of Nanjing Medical University, 10.1016/S1007-4376(09)60072-1, 23:4, (289-292), Online publication date: 1-Jul-2009. Artham S, N'Dandu Z and Jenkins J (2007) Apical Ballooning Syndrome or Takotsubo Syndrome: A Novel Cardiac Syndrome, Congestive Heart Failure, 10.1111/j.1527-5299.2007.06698.x, 13:6, (352-355), Online publication date: 1-Nov-2007. El Mahmoud R, Leyer F, Michaud P, Nallet O and Cattan S (2006) Ballonisation apicale transitoire du ventricule gauche ou syndrome de tako-tsubo, Annales de Cardiologie et d'Angéiologie, 10.1016/j.ancard.2006.01.002, 55:4, (210-215), Online publication date: 1-Aug-2006. Grawe H, Katoh M and Kühl H (2006) Stress cardiomyopathy mimicking acute coronary syndrome: case presentation and review of the literature, Clinical Research in Cardiology, 10.1007/s00392-006-0346-2, 95:3, (179-185), Online publication date: 1-Mar-2006. Aurigemma G and Tighe D (2006) Echocardiography and Reversible Left Ventricular Dysfunction, The American Journal of Medicine, 10.1016/j.amjmed.2005.10.031, 119:1, (18-21), Online publication date: 1-Jan-2006. Donohue D and Movahed M (2006) Clinical Characteristics, Demographics and Prognosis of Transient Left Ventricular Apical Ballooning Syndrome, Heart Failure Reviews, 10.1007/s10741-005-8555-8, 10:4, (311-316), Online publication date: 1-Dec-2005. Dec G (2005) Recognition of the Apical Ballooning Syndrome in the United States, Circulation, 111:4, (388-390), Online publication date: 1-Feb-2005.Sharkey S, Lesser J, Zenovich A, Maron M, Lindberg J, Longe T and Maron B (2005) Acute and Reversible Cardiomyopathy Provoked by Stress in Women From the United States, Circulation, 111:4, (472-479), Online publication date: 1-Feb-2005. Ohara Y, Hiasa Y, Hosokawa S, Tomokane T, Yamaguchi K, Ogura R, Miyajima H, Ogata T, Yuba K, Suzuki N, Takahashi T, Kishi K and Ohtani R (2005) Left Ventricular Free Wall Rupture in Transient Left Ventricular Apical Ballooning, Circulation Journal, 10.1253/circj.69.621, 69:5, (621-623), . Fritz J, Wittstein I, Lima J and Bluemke D (2005) Transient Left Ventricular Apical Ballooning, Journal of Computer Assisted Tomography, 10.1097/01.rct.0000148454.67697.42, 29:1, (34-36), Online publication date: 1-Jan-2005. (2004) Conditions Associated with ST-Segment Elevation, New England Journal of Medicine, 10.1056/NEJM200403113501118, 350:11, (1152-1155), Online publication date: 11-Mar-2004. October 21, 2003Vol 108, Issue 16 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000079313.93444.F1PMID: 14568886 Originally publishedOctober 21, 2003 PDF download Advertisement