Transient left ventricular apical ballooning syndrome: a 4-year experience

Area of Science:

• Cardiology
• Internal Medicine
• Medical Research

Background:

• Transient left ventricular apical ballooning syndrome (LVABS), also known as Takotsubo cardiomyopathy, was initially described in Japanese patients.
• Recent observations indicate its occurrence outside Japan, prompting further investigation into its epidemiology and clinical profile in diverse populations.

Purpose of the Study:

• To determine the incidence and clinical characteristics of LVABS in a tertiary-care hospital setting in northeastern Italy.
• To compare findings with previously reported cases, particularly those from Japan.

Main Methods:

• A retrospective analysis of patients admitted between January 2002 and August 2006 with suspected acute coronary syndrome.
• Application of the Mayo Clinic Criteria for diagnosis of LVABS.
• Review of patient demographics, clinical presentation, risk factors, ECG, echocardiography, and coronary angiography findings.

Main Results:

• Twenty-nine patients (25 women, mean age 64 years) met the criteria for LVABS.
• Emotional or physiologic stress preceded the event in 69% of cases.
• Coronary angiography revealed no significant coronary artery disease in 79% of patients.
• Complete recovery of ECG and echocardiographic abnormalities was observed within 10 weeks, with no in-hospital mortality or major complications.

Conclusions:

• LVABS is a distinct clinical entity with a significant incidence, presenting symptoms similar to acute myocardial infarction.
• The syndrome predominantly affects women and is frequently associated with emotional stress.
• While diagnosis can be challenging, a combination of ECG, echocardiography, and coronary angiography is crucial for differentiation from acute myocardial infarction, and the prognosis is generally favorable.