Isolated left ventricular basal ballooning phenotype of transient cardiomyopathy in young women

Am J Cardiol. 2007 May 15;99(10):1451-3. doi: 10.1016/j.amjcard.2006.12.078. Epub 2007 Apr 11.

Abstract

This report describes a variant of transient regional left ventricular dysfunction in which isolated basal left ventricular akinesia with normal mid-ventricular (papillary-level) wall motion and apical hypercontractility were noted in young women (mean age 31 years). This finding was demonstrated in 3 consecutive patients; the first patient was experiencing emotional life-altering events, and the second presented with an acute flare of multiple sclerosis. The third patient presented < 24 hours after methamphetamine use. Coronary angiography demonstrated normal epicardial coronary arteries in all patients. Wall motion abnormalities resolved within 2 to 6 weeks. In conclusion, the entity described in this report is reminiscent of apical ballooning ("Tako-Tsubo"), mid-ventricular ballooning, and apical sparing syndromes; however, isolated basal left ventricular involvement has not been previously described and is a newer variant in the spectrum of transient cardiomyopathies. The pathophysiology of this entity has not been elucidated. A unifying feature between the transient cardiomyopathic syndromes most likely is in the concentration, distribution, and activity of cardiac adrenergic receptors.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cardiomyopathy, Dilated / diagnostic imaging
  • Cardiomyopathy, Dilated / drug therapy
  • Cardiomyopathy, Dilated / etiology*
  • Cardiomyopathy, Dilated / physiopathology*
  • Dilatation, Pathologic / complications
  • Dilatation, Pathologic / drug therapy
  • Dilatation, Pathologic / physiopathology
  • Echocardiography
  • Female
  • Humans
  • Stroke Volume / drug effects
  • Ventricular Dysfunction, Left / complications*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / physiopathology*

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors