Document Detail

Transient left ventricular apical ballooning syndrome: a 4-year experience.
MedLine Citation:
PMID:  18695429     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transient left ventricular apical ballooning syndrome, primarily described in Japanese patients, has been recently recognized outside Japan also. Aim of this study is to elucidate incidence and clinical features of left ventricular apical ballooning syndrome in a tertiary-care hospital in northeastern Italy. METHODS AND RESULTS: From January 2002 to August 2006, 29 patients admitted for suspected acute coronary syndrome (25 women, mean age 64+/-12 years) fulfilled the Mayo Clinic Criteria of left ventricular apical ballooning syndrome. Twenty patients (69%) had an episode of emotional or physiologic stress preceding left ventricular apical ballooning syndrome. Fourteen patients (48%) had at least one risk factor for coronary artery disease. Chest pain was present at admission in 24 patients (83%). Twenty-five patients (86%) had ST-T segment abnormalities at ECG on admission. Four patients were treated with fibrinolytic therapy and one with glycoprotein IIb/IIIa inhibitors. At coronary angiography, 23 patients (79%) had no coronary lesions, 2 (7%) had small vessel occlusion and 4 (14%) had nonsignificant coronary stenosis. ECG changes and echocardiographic wall motion abnormalities completely regressed in all patients within 10 weeks. Neither death nor major complications occurred during in-hospital stay and after discharge. Two patients (7%) experienced a recurrence during follow-up. CONCLUSION: Left ventricular apical ballooning syndrome is a novel syndrome with a nonnegligible incidence, a clinical presentation mimicking acute myocardial infarction and a favorable outcome. The present data confirm a higher prevalence in women and the frequent association with emotional stress. The differential diagnosis with acute myocardial infarction at presentation is still puzzling, and only ECG findings in conjunction with echocardiography and coronary angiography are so far diagnostics.
Leonardo Spedicato; Davide Zanuttini; Gaetano Nucifora; Claudia Sciacca; Luigi P Badano; Giorgio Minen; Giorgio Morocutti; Guglielmo Bernardi; Paolo M Fioretti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  9     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-12     Completed Date:  2008-11-04     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  916-21     Citation Subset:  IM    
Department of Cardiopulmonary Sciences, University Hospital Santa Maria della Misericordia, Udine, Italy.
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MeSH Terms
Heart Catheterization
Middle Aged
Risk Factors
Takotsubo Cardiomyopathy / diagnosis*,  etiology
Comment In:
J Cardiovasc Med (Hagerstown). 2009 Feb;10(2):204-5   [PMID:  19377386 ]

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