[Atypical acute myocardial ischemia syndrome with reversible left ventricular (LV) wall motion abnormalities ("apical ballooning") without significant coronary artery disease]

Abstract

We report on three patients with acute myocardial ischemia syndrome, without significant coronary artery disease, who were admitted within one year in our hospital and presenting an atypical balloon-like, reversible left ventricular apical wall motion abnormality. The reported cases showed the following similarities: 1) elderly women (age >65 years), 2) triggered by physical or emotional stress, 3) dynamic reversible ST-T segment abnormalities and 4) positive troponin I. During a one year follow-up, all patients remained asymptomatic. As compared to the usual forms of the acute coronary ischemia syndrome, this syndrome showed a unique balloon-like left ventricular (LV) wall motion abnormality at the apex, which did not correlate with the coronary supply of a major coronary vessel. The etiology and pathophysiological basis of this coronary syndrome, which has previously been described in Japan, is still not well understood.