Document Detail

Apical ballooning of the left ventricle: first series in white patients.
MedLine Citation:
PMID:  12923018     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A cardiac syndrome of "apical ballooning" was recently described, consisting of an acute onset of transient extensive akinesia of the apical and mid portions of the left ventricle, without significant stenosis on the coronary angiogram, accompanied by chest symptoms, ECG changes, and a limited release of cardiac markers disproportionate to the extent of akinesia. Until now, this syndrome has been reported only in Japanese patients. OBJECTIVE: To describe 13 white patients who presented with this syndrome over the previous four years. RESULTS: All but one of the patients were women with a mean age of 62 years. Eight of them presented with chest pain, of whom six had cardiogenic shock. In nine patients a triggering factor was identified: emotional stress in three, trauma in one, pneumonia in one, asthma crisis in one, exercise in two, and cerebrovascular accident in one. In all patients left ventriculography showed very extensive apical akinesia ("apical ballooning") in the absence of a significant coronary artery stenosis, not corresponding with the perfusion territory of a single epicardial coronary artery. Mean maximal creatine kinase MB and troponin rise were 27.4 microg/l (range 5.2-115.7 microg/l, median 16.6 microg/l) and 18.7 microg/l (range 2.0-97.6 microg/l, median 14.5 microg/l), respectively. Six patients were treated with intra-aortic balloon counterpulsation. One patient died of multiple organ failure. On necropsy, no myocardial infarction was found. In the 12 survivors, left ventricular systolic function recovered completely within three weeks. CONCLUSIONS: This is the first series of "apical ballooning" to be reported in white patients. Despite dramatic initial presentation, left ventricle function recovered completely within three weeks in the survivors.
W J R Desmet; B F M Adriaenssens; J A Y Dens
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  89     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-18     Completed Date:  2003-09-23     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1027-31     Citation Subset:  AIM; IM    
UH Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
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MeSH Terms
Aged, 80 and over
Chest Pain / etiology
Coronary Angiography
Creatine Kinase / blood
Creatine Kinase, MB Form
European Continental Ancestry Group*
Intra-Aortic Balloon Pumping
Isoenzymes / blood
Middle Aged
Shock, Cardiogenic / etiology
Troponin I / blood
Ventricular Dysfunction, Left / ethnology*,  radiography,  therapy
Reg. No./Substance:
0/Isoenzymes; 0/Troponin I; EC Kinase; EC Kinase, MB Form
Comment In:
Heart. 2003 Sep;89(9):974-6   [PMID:  12922993 ]

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