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[Left ventricular apical ballooning].

M Kotzerke1, M Keim, Ch Haller

  • 1I. Medizinische Klinik, Hegau-Bodensee-Kliniken, Singen. michael.kotzerke@hegau-klinikum.de

Deutsche Medizinische Wochenschrift (1946)
|October 22, 2004
PubMed
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Left apical ballooning, a rare cause of cardiac ischemia without coronary artery disease, presents as a reversible left ventricular dysfunction. This condition, characterized by a "ballooned" apex, shows a good prognosis after initial recovery.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Acute coronary syndrome (ACS) is a common presentation of cardiac ischemia.
  • Coronary artery disease (CAD) is the primary cause of ACS.

Observation:

  • Two patients presented with symptoms of ACS, ECG changes, and elevated troponin-I.
  • Echocardiography revealed severely reduced left ventricular function with apical akinesis and a "ballooned" apex.
  • Coronary angiography excluded significant coronary artery stenosis.

Findings:

  • A diagnosis of "apical ballooning" was made, characterized by reversible left ventricular dysfunction in the absence of CAD.
  • Left ventricular function completely recovered within four weeks in both patients without specific treatment.

Implications:

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  • Apical ballooning is an increasingly recognized diagnosis mimicking ACS.
  • The pathogenesis remains unknown, but the prognosis is favorable for survivors of the acute phase.
  • This condition highlights the importance of considering non-CAD causes of myocardial ischemia.