title: Apical ballooning syndrome in a postoperative patient with normal microvascular perfusion by myocardial contrast echocardiography.
abstract: Apical ballooning syndrome is classically described as transient left ventricular (LV) dysfunction, marked LV akinesia, and normal or near-normal coronary arteries. The etiology is unclear and there is limited information based on case reports and small case series. We describe a 35-year-old woman who underwent surgical hepatectomy and developed apical ballooning syndrome in the postoperative period. The novel use of myocardial contrast echocardiography (MCE) in this setting demonstrated intact microvascular perfusion and lack of coronary flow-limiting abnormalities despite apical akinesis. In select patients with similar clinical presentations, performing MCE is safe and may be pursued as an alternative to invasive coronary angiography.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA.
authors.forename: Gautam
authors.initials: G
authors.lastname: Ramakrishna
authors.forename: Barugur S
authors.initials: BS
authors.lastname: Ravi
authors.forename: Krishnaswamy
authors.initials: K
authors.lastname: Chandrasekaran
mesh_terms: D000328:Adult; D003287:Contrast Media; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D005466:Fluorocarbons; D006498:Hepatectomy; D006801:Humans; D008863:Microspheres; D009200:Myocardial Contraction; D011183:Postoperative Complications; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren