title: [Takotsubo, reversible apical ballooning of the left ventricle. Report of 4 cases].
abstract: A syndrome of apical ballooning, with ECG mimicking acute myocardial infarctation, mild or no enzymatic changes, and normal coronary angiogram was described in 1990. It presents mainly in middle aged and elderly women and it is preceded by stress triggering circumstances. Several mechanisms have been proposed although the precise cause remains unclear. The most accepted theory proposes the interaction of catecholamines and an inadequate inotropic response. We report four cases that presented with chest pain and sudden onset of heart failure, all patients had physical or emotional stress as a triggering factor. On ECG, ST segment elevation and inverted T waves were observed in the acute phase. All patients had typical echocardiogram image and normal coronary angiogram. Both ECG and echocardiogram returned to normal within two weeks.
authors.affiliation: Servicio de Clínica Médica, Hospital Británico, Buenos Aires. barbarafinn73@hotmail.com
authors.forename: Bárbara C
authors.initials: BC
authors.lastname: Finn
authors.forename: Pablo
authors.initials: P
authors.lastname: Young
authors.forename: Julio E
authors.initials: JE
authors.lastname: Bruetman
mesh_terms: D000368:Aged; D004108:Dilatation, Pathologic / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D013312:Stress, Physiological / Q000503:physiopathology; D013577:Syndrome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology