Incidence, Clinical Findings, and Outcome of Women With Left Ventricular Apical Ballooning Syndrome

Guido Parodi, Stefano Del Pace, Nazario Carrabba, Claudia Salvadori, Gentian Memisha, Ignazio Simonetti, David Antoniucci, Gian Franco Gensini

Research output: Contribution to journalArticlepeer-review

Abstract

Left ventricular apical ballooning syndrome (LVABS) is a clinical condition that may mimic ST-elevation acute myocardial infarction (AMI). To assess incidence, clinical findings, and outcome of white women with LVABS, we reviewed 305 consecutive women with chest pain and anterior ST-elevation AMI referred for potential mechanical revascularization; 36 (12%) patients met the diagnostic criteria for LVABS and were compared with the remaining 269 women with angiographic evidence of coronary artery disease (CAD). Patients with LVABS showed a lower incidence of diabetes mellitus (5% vs 21%, p = 0.023), a higher rate of antecedent stressful events (26% vs 3%, p 50% stenosis) in the 269 control women (p = 0.0001). Peak creatine kinase-MB value was lower in patients with LVABS (21 ± 26 mU/ml) than in women with CAD (307 ± 302 mU/ml, p = 0.0001). The only independent predictors of LVABS among women with anterior AMI were peak creatine kinase-MB value (p = 0.0001) and the presence of an antecedent stressful event (p = 0.001). LV systolic function at admission was similar between women with LVABS and those with CAD (echocardiographic ejection fraction 35.6 ± 8.4% vs 35.5 ± 8.0%, p = 0.944) but was significantly different at discharge (ejection fraction 50.1 ± 9.6% vs 45.2 ± 13.5%, p = 0.021). Moreover, at 6-month follow-up, women with LVABS showed a better survival rate (97% vs 86%, p = 0.055) and freedom from major cardiac events (death, reinfarction, or rehospitalization 92% vs 69%, p = 0.001) than women with CAD. In conclusion, few women presenting with clinical features of anterior AMI have LVABS. Despite a favorable outcome, LVABS should be considered in the differential diagnosis of women with chest pain and ST-segment elevation in the precordial leads. Peak creatine kinase-MB value and the presence of an antecedent stressful event are strong predictors of LVABS in women with anterior AMI.

Original languageEnglish
Pages (from-to)182-185
Number of pages4
JournalThe American Journal of Cardiology
Volume99
Issue number2
DOIs
Publication statusPublished - Jan 15 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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