Left ventricular apical ballooning: Not an uncommon variant of acute myocardial infarction in women

Background: Left ventricular apical ballooning, a new syndrome recently described in Japan, is characterized by chest pain, electrocardiographic changes mimicking acute myocardial infarction, and transient apical dyskinesia with normal coronary arteries. Although several studies have defined the clinical characteristics, the prevalence of this syndrome remains unclear. Hypothesis: This study sought to determine the prevalence of left ventricular apical ballooning syndrome. Methods: From January 2002 to September 2004, clinical, echocardiographic, and angiographic data of hospitalization and follow-up were collected from 638 consecutive patients referred to our Heart Institute for primary percutaneous intervention. Results: Thirteen patients (2%) were diagnosed with transient left ventricular apical ballooning. All but one patient were women, representing a 6% incidence for the female patients with acute myocardial infarction. A triggering factor was identified in eight. One patient died of cardiogenic shock. Left ventricular systolic function recovered completely within 4-5 weeks in the remaining 12 survivors. Conclusion: This syndrome is not uncommon and should be considered particularly in female patients presenting with acute myocardial infarction.