This report describes the clinical characteristics of 8 consecutive patients with
transient left ventricular apical ballooning identified among 389 patients (2%) admitted
to a tertiary referral hospital with suspected acute coronary syndromes over a 1-year
period. Among these patients, 2 cases appeared to be caused by acute myocarditis and
1 case by head trauma with intracranial bleeding. In the remaining 5 cases, no apparent
cause was found. All patients but 1 were postmenopausal women (mean age 60 ± 13.5
years). Preceding strong emotional or physical stress was present in 6 patients. The
presenting symptom in 7 patients was chest pain. Four patients had significant ST-segment
elevation, and the remaining 4 had T-wave inversions on their admission electrocardiograms.
Mean peak troponin I was moderately elevated (3.7 ± 4.5 ng/dl). The mean echocardiographic
left ventricular ejection fraction was 40 ± 10% on admission and increased significantly
to 63 ± 4% at 1-month follow-up (p <0.0001). All patients but 1 had abnormal corrected
Thrombolysis In Myocardial Infarction frame counts (>27 frames) in ≥1 major epicardial
coronary artery. All patients were alive and without major adverse cardiac events
at 6-month follow-up. In conclusion, transient left ventricular apical ballooning
should be considered in the differential diagnosis of patients presenting with suspected
acute coronary syndromes, because it may account for approximately 2% of hospital
admissions.
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Article Info
Publication History
Published online: September 18, 2006
Accepted:
May 18,
2006
Received in revised form:
May 18,
2006
Received:
February 7,
2006
Identification
Copyright
© 2006 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
