Open AccessTransient Cardiac Ballooning—The Syndrome
Author(s) -
Gupta Raghav,
Sech Candice,
Lazzara Ralph
Publication year - 2009
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20652
Subject(s) - medicine , cardiology , myocardial stunning , pathophysiology , hyperkinesis , chest pain , electrocardiography , coronary artery disease , ischemia
Transient cardiac ballooning is usually a reversible clinical entity. A patient typically presents with chest pain, electrocardiogram (ECG) abnormalities like ST‐segment elevation (most commonly reported) or depression, and elevated cardiac enzymes, but has no or nonobstructive coronary artery disease. Left ventriculography reveals transient akinesis of the involved portion of the myocardial wall with compensatory hyperkinesis of the remaining myocardium, leading to ballooning of the noncontracting myocardial wall during systole. Acute regional myocardial dysfunction ensues, which normalizes on average within 1 to 6 weeks. The hypotheses for these pathophysiologic changes range from direct cardiac myocyte injury to postischemic myocardial stunning to neurotransmitter actions. The objective of this article is to present a succinct description of a small case series accompanied with various recently reported presentations and morphology by left ventriculogram and a detailed review of available data on underlying pathophysiology. In addition, a discussion on current diagnostic guidelines, treatment, prognosis, and potential future investigations is included. Copyright © 2009 Wiley Periodicals, Inc.