Transient left midventricular ballooning without apical involvement

We present a case of a 51-years-old woman with acute chest pain and ECG showing diffuse ST segment deviation who was transferred to our hospital to perform an urgent coronary angiography. There were no significant obstructions and left ventriculography (LVG) showed a midventricular ballooning without the apical dysynergy described previously in Tako-Tsubo or stress-induced cardiomyopathy. She had a favourable hospital course and a new LVG at 30 days showed total normalization of contractility. This recently described new pattern of transient left ventricular dysfunction was probably induced by a great mental stress state that the patient described in the preceding 24–48 h and the intrinsic mechanism could be a direct catecholamine myocardial damage or a microcirculation spasm.