Left-ventricular apical ballooning

Transient left-ventricular apical ballooning (Tako-Tsubo syndrome)... 

Ibanez B, Navarro F, Farre J et al. Tako-Tsubo transient left ventricular apical ballooning is associated with a left anterior descending coronary artery with a long course along the apical diaphragmatic surface of the left ventricle. Rev Esp Cardiol 2004 57 209. 

Previtali M, Repetto A, Scuteri L. Dobutamine induced severe midventricular obstruction and mitral regurgitation in left ventricular apical ballooning syndrome. Heart 2005 91(3) 353. 

Cardiovascular Tako-Tsubo syndrome is transient left ventricular apical ballooning, very similar to acute myocardial infarction. 

Varieties There are three main types left ventricular apical ballooning (classical takotsubo cardiomyopathy), an inverted or reverse variant (basal akinesb with a hyperdynamic apex, abo called the artichoke heart ), and a midventricular variant. 

Arora S, Alfayoumi F, Srinivasan V. Transient left ventricular apical ballooning after cocaine use is catecholamine cardio-toxicity the pathologic link Mayo Clin Proc 2006 81(6) 829-32. 

Fujiwara S, Takeishi Y, Isoyama S, Aono G, Takizawa K, Honda H, Otomo T, Mitsuoka M, Itoh Y, Terashima M, Kubota I, Meguro T. Responsiveness to dobutamine stimulation in patients with left ventricular apical ballooning syndrome. Am J Cardiol 2007 100(10) 1600-3. 

Kumar A, Jenkins LA, Perez-Verdia A, Roongsritong C. Transient left ventricular apical ballooning during dobutamine myocardial perfusion imaging. Int J Cardiol... 

Sonmez O, Duman C, Duzenli MA, Tokac M. Special attention for elderly women atypical left ventricular apical ballooning syndrome induced by dobutamine stress test a case report. J Am Geriatr Soc 2009 57(9) 1735-6. 

Jefic D, Koul D, Boguszewski A, Martini W. Transient left ventricular apical ballooning syndrome caused by abrupt metoprolol withdrawal. Int J Cardiol 2008 131 e35-7. 

Catecholamines do not improve function in the apical ballooning syndrome and may make it worse. In 11 patients cm infusion of low-dose dobutamine did not improve the akinetic wcdl motion, despite the hypercontractile basal left ventricular wcdl, and despite the fact that the syndrome is reversible [29 ]. In other cases, takotsubo syndrome was worsened by infusion of catecholamines (in one case adrenaline, dobutamine, and noradrenaline and in another dopamine) and improved when the catecholamines were withdrawn [30, 31 ] beta-blockade was beneficial... 

Reversible severe left ventricular systolic dysfunction with apical ballooning has abo been reported during dobutamine stress echocardiography [45, 46, 47, 48, 49, 50, 51, 52, 53, 54 ] and abo in one case after recovery from stress echocardiography [55 ]. In one case it occurred in a patient with previous orthotopic heart transplantation [56 ]. In another case it occurred in a patient who had had a subarachnoid haemorrhage [57 ], in which sympathetic nervous system activity b increased and in which acute myocardial infarction can abo occur. 

Cherian J, Kothari S, Angelis D, Atef A, Downey B, Kirkpatrick Jr. J. Atypical takotsubo cardiomyopathy dobutamine-precipitated apical ballooning with left ventricular outflow tract obstruction. Tex Heart Inst J 2008 35(1) 73-5. 

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