+1 Recommend
0 collections
      • Record: found
      • Abstract: not found
      • Article: not found

      Assessment of clinical features in transient left ventricular apical ballooning

      , , , , ,

      Journal of the American College of Cardiology

      Elsevier BV

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          We sought to assess the clinical features of transient left ventricular (LV) apical ballooning. Although several cases regarding transient LV apical ballooning have been reported, the etiology remains unknown. We investigated 17 patients (14 women, median age 74 years old with a range of 54 to 91 years old) who fulfilled the following criteria: 1) transient LV apical ballooning; 2) ST-T segment change in several leads in electrocardiogram; and 3) no history of old myocardial infarction, valvular heart disease, subarachnoid hemorrhage, or pheochromocytoma. Emotional and physical stress were observed in 16 patients (94%). Technetium-99m tetrofosmin tomographic imaging revealed decreased uptake at the apex of the left ventricle in 11 patients (85%) that later returned to uniform. No significant stenosis or angiographical slow flow in epicardial coronary arteries was observed (n = 9). Provocative focal vasospasm was induced in only one patient (14%) (n = 7). Moreover, no significant abnormality in the coronary microcirculation was detected by Doppler guidewire (n = 3) or contrast echocardiography (n = 1). No patients showed a rise in viral antibody titers. Biopsy specimens revealed interstitial fibrosis in six patients (100%) and slight cell infiltration in three others (50%) (n = 6). These findings suggested that neither abnormalities in the coronary circulation nor acute myocarditis was related to the etiology. Although neurogenic stunned myocardium induced by emotional or physical stress was suggested as the etiology, further investigations are necessary.

          Related collections

          Author and article information

          Journal of the American College of Cardiology
          Journal of the American College of Cardiology
          Elsevier BV
          March 2003
          March 2003
          : 41
          : 5
          : 737-742
          © 2003


          Comment on this article