Echocardiography and Reversible Left Ventricular Dysfunction

Purpose Transient apical ballooning is increasingly recognized in acutely ill, hospitalized patients. This article reviews clinical aspects of the syndrome, its recognition by echocardiography, and will review other disorders whose recognition is due primarily to the availability of echocardiography. Methods Systematic review of the medical literature concerning the syndrome of transient apical ballooning. Results Seven recent studies of transient apical ballooning are reviewed; the clinical characteristics, biomarker data, echocardiographic findings, and angiographic data are remarkably similar. Most afflicted individuals are women in their seventh decade who develop chest symptoms in close relationship to a “trigger” event—this is usually either severe emotional distress, a medical illness, or a procedure. Conclusions Transient apical ballooning is not uncommonly encountered among acutely ill, hospitalized patients with chest symptoms. As yet there is no consensus of the underlying mechanism, although there is reason to believe that catecholamine injury to the myocardium is partially, if not wholly responsible. The widespread use of echocardiography appears to be responsible for the increasing recognition of this (and other) syndromes.