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REVIEW

Systematic Review: Transient Left Ventricular Apical Ballooning: A Syndrome That Mimics ST-Segment Elevation Myocardial Infarction

right arrow Kevin A. Bybee, MD; Tomas Kara, MD, PhD; Abhiram Prasad, MD, MRCP; Amir Lerman, MD; Greg W. Barsness, MD; R. Scott Wright, MD; and Charanjit S. Rihal, MD

7 December 2004 | Volume 141 Issue 11 | Pages 858-865

The transient left ventricular apical ballooning syndrome, also known as takotsubo cardiomyopathy, is characterized by transient wall-motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of obstructive epicardial coronary disease. In this paper, we review case series that report on patients with the transient left ventricular apical ballooning syndrome to better characterize patients presenting with the syndrome.

We identified 7 case series that reported on at least 5 consecutive patients with the transient left ventricular apical ballooning syndrome. The syndrome more often affects postmenopausal women (82% to 100%) (mean age, 62 to 75 years). Patients commonly present with ST-segment elevation in the precordial leads, chest pain, relatively minor elevation of cardiac enzyme and biomarker levels, and transient apical systolic left ventricular dysfunction despite the absence of obstructive epicardial coronary disease. An episode of emotional or physiologic stress frequently precedes presentation with the syndrome. The in-hospital mortality rate seems to be low, as does the risk for recurrence.

Author and Article Information
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From Mayo Clinic College of Medicine, Rochester, Minnesota.

Potential Financial Conflicts of Interest:Consultancies: R.S. Wright (Bayer); Grants received: R.S. Wright (Centocor, Merck, Bayer, Bristol-Myers Squibb).

Requests for Single Reprints: Charanjit S. Rihal, MD, Cardiac Catheterization Laboratory, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905; e-mail, Rihal{at}mayo.edu.

Current Author Addresses: Drs. Bybee, Kara, Prasad, Lerman, Barsness, Wright, and Rihal: Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905.


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Rapid Responses:

Read all Rapid Responses

Transient left ventricular apical ballooning: is acute coronary syndrome exclusion correct?
Borja Ibanez, et al.
Annals Online, 15 Dec 2004 [Full text]
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Junya Ako, et al.
Annals Online, 4 Jan 2005 [Full text]
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Reza Alizadeh Dehnavi, et al.
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Mori J Krantz
Annals Online, 6 Jan 2005 [Full text]
Author response to comments
Charanjit S. Rihal, et al.
Annals Online, 18 Jan 2005 [Full text]
Authors' Reply
Charanjit S. Rihal, et al.
Annals Online, 27 Jan 2005 [Full text]



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