Apical myocardial infarction with bizarre coronary images mimicking left ventricular apical ballooning syndrome: a case report.
BACKGROUND
Although several etiopathogenetic mechanisms have been proposed, the causes of left ventricular apical ballooning syndrome are still controversial.


METHODS
A 51-year-old Japanese woman consulted the emergency room complaining of the sudden onset of anterior chest pain while shopping. We initially suspected her disease as left ventricular apical ballooning syndrome based on her clinical background and laboratory examinations. However, the initial coronary angiogram demonstrated diffuse lesions in her distal left anterior descending coronary artery, and she was finally diagnosed with apical myocardial infarction. The blood flow in her distal left anterior descending coronary artery had markedly improved in the chronic phase. If the reduced blood flow in her distal left anterior descending coronary artery was induced by coronary vasospasm and the vasospasm was relieved before the coronary angiogram was performed, this case must be diagnosed as left ventricular apical ballooning syndrome.


CONCLUSIONS
We think this case may promote discussion regarding the pathophysiology of left ventricular apical ballooning syndrome.
Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan. t2-ya@nike.eonet.ne.jp.
Tetsuya
T
Nomura
Natsuya
N
Keira
Shunta
S
Taminishi
Hiroshi
H
Kubota
Yusuke
Y
Higuchi
Sho
S
Ikegame
Kensuke
K
Terada
Taku
T
Kato
Yota
Y
Urakabe
Tetsuya
T
Tatsumi
D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000000981:diagnostic imaging