title: Apical ballooning syndrome and previous coronary artery disease: a novel relationship.
abstract: Apical transient left ventricular diskynesia is a recently described entity able to imitate acute coronary syndrome. The presence of previous coronary artery disease (CAD) is an exclusion criterion for this diagnosis in several studies. We report the case of a sixty-three year-old-caucasian man with previously known CAD, left anterior descending artery (LAD) stented-disease, presenting in the emergency room with angina and ST-segment elevation. A coronariography was urgently performed. No new coronary lesions could be demonstrated. LAD-placed stents were patent and showed no change in their angiographic appearance. Left ventriculogram demonstrated apical diskynesia (Takotsubo-like). Complete and rapid resolution of left ventricular dysfunction was echocardiographycally displayed seven days later. Months after, coronary lesions increased associated with new acute coronary syndromes and new revascularization procedures were required. The present case supports the idea that CAD and apical transient diskynesia could coexist in the same patient, arising further questions about the pathophysiology, prognosis and management of the latter.
authors.forename: Iván Javier
authors.initials: IJ
authors.lastname: Núñez-Gil
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Rubira
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Ortiz
authors.forename: David
authors.initials: D
authors.lastname: Vivas
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Gonzalez
authors.forename: María
authors.initials: M
authors.lastname: Luaces
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*