Isolated left ventricular basal ballooning phenotype of transient cardiomyopathy in young women.
This report describes a variant of transient regional left ventricular dysfunction in which isolated basal left ventricular akinesia with normal mid-ventricular (papillary-level) wall motion and apical hypercontractility were noted in young women (mean age 31 years). This finding was demonstrated in 3 consecutive patients; the first patient was experiencing emotional life-altering events, and the second presented with an acute flare of multiple sclerosis. The third patient presented < 24 hours after methamphetamine use. Coronary angiography demonstrated normal epicardial coronary arteries in all patients. Wall motion abnormalities resolved within 2 to 6 weeks. In conclusion, the entity described in this report is reminiscent of apical ballooning ("Tako-Tsubo"), mid-ventricular ballooning, and apical sparing syndromes; however, isolated basal left ventricular involvement has not been previously described and is a newer variant in the spectrum of transient cardiomyopathies. The pathophysiology of this entity has not been elucidated. A unifying feature between the transient cardiomyopathic syndromes most likely is in the concentration, distribution, and activity of cardiac adrenergic receptors.
Reuss
Christina S
CS
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA. reuss.christina@mayo.edu
Lester
Steven J
SJ
Hurst
R Todd
RT
Askew
J Wells
JW
Nager
Paul
P
Lusk
Joan
J
Altemose
Gregory T
GT
Tajik
A Jamil
AJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D004108:Dilatation, Pathologic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D013318:Stroke Volume / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors