Apical Ballooning Syndrome or Tako-tsubo Cardiomyopathy: What We Know About It

Apical ballooning syndrome (ABS) is a reversible cardiomyopathy with presentation mimicking an acute coronary syndrome. So in clinical practice, it is essential to consider it in the differential diagnosis of patients presenting with chest pain, especially in postmenopausal women. Coronary angiography is usually indicated to achieve a proper diagnosis. Typically, patients do not have significant coronary artery lesions. Left ventriculography and echocardiography reveal a regional systolic dysfunction with akinesis of the midventricle, apex and compensatory hyperkinesis of the basal ventricular segments. Occurrence of an emotionally or physically stressful event is a feature of ABS but its absence does not exclude this diagnosis. Several pathophysiologic mechanisms had been proposed. The prognosis of ABS is good. In this review, we highlight the clinical manifestations, pathophysiology and management of this syndrome.