Transient biventricular apical ballooning: a unique presentation of the "broken heart".
Transient left ventricular (LV) apical ballooning and normal epicardial coronary arteries are the hallmarks of Takotsubo cardiomyopathy. The syndrome is often triggered by emotional or physiologic stress, and its pathogenesis is poorly understood. Current proposals focus on elevated cathecolamines in association with abnormal coronary artery endothelium, coronary microcirculation or LV geometry. Right ventricular (RV) involvement, as described in our patient, is not reported as a typical feature. Presence of RV dysfunction may affect the initial management of these patients and raises questions regarding the universal applicability of the currently proposed pathophysiologic mechanisms of this syndrome.
General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania 17822-2160, USA.
Gregg
G
Novak
Kimberly
K
Kross
Kristy
K
Follmer
Alessandra
A
Brofferio
Jamshid
J
Shirani
D000368:Aged; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging / Q000503:physiopathology*