Vol 13, No 6 (2006): Folia Cardiologica
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Published online: 2006-07-10

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Short and long term follow-up of patients with transient left ventricular apical ballooning

Tomasz Pawłowski, Robert J. Gil, Jarosław Rzezak, Hanna Rdzanek, Marcin Młotek
Folia Cardiol 2006;13(6):511-516.


Background: Transient left ventricular apical ballooning (TLVAB) was described in Japan as the syndrome characterized by balloon-like left ventricular wall abnormalities without accompanying coronary atherosclerosis. The aim of the study was to evaluate the short and long-term follow-up of our patients with TLVAB.
Methods: The population of 1869 patients with the preliminary diagnosis of acute coronary syndrome was screened. We collected data regarding clinical course, physical or emotional trauma, ECG abnormalities, presence of balloon-like left ventricular abnormality. During follow-up, the data on cardiac events (death, recurrence of chest pain, re-hospitalization) were collected. Serial echocardiographic scans were performed to follow the TLVAB regression.
Results: Thirty (1.6%) patients (only women, mean age 72 ± 12 y) showed characteristic left ventricle abnormalities. There was an evidence of significant trauma (40% physical and 60% emotional) in every patient. ECG analysis showed negative T waves in anterior leads in 93% and ST elevation in 7% of the patients. Maximal MB creatine kinase and troponin I levels were 38 ± 12 U/l and 1.12 ± 0.75 ng/dl, respectively. The clinical course during hospitalization was benign in 96% and only in one patient (4%) the pulmonary oedema occurred. During follow-up (6-24 months, mean 12 months), there were two cases of chest pain recurrence, but without clinical features of TLVAB (examined by echo or angiography). Mean time for left ventricular abnormalities regression was 3 ± 1 months.
Conclusions: The transient left ventricular apical ballooning is a benign syndrome mimicking acute coronary syndrome with good long term outcome.

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