A case of transient left ventricular apical ballooning syndrome in a child: clinical features and imaging findings

Abstract

Transient left ventricular apical ballooning syndrome (TLVABS) is an acute cardiac disease that is characterized by transient left ventricular systolic dysfunction involving the apical region. The symptoms and electrocardiographic changes of TLVABS mimic those observed in acute myocardial infarction while obstructive coronary arterial lesions are not seen in patients with TLVABS. TLVABS usually occurs in elderly women after physical or emotional stress. However, it is very rare in children and so it not well known to pediatricians. Accordingly, TLVABS in children can be misdiagnosed as myocarditis or cardiomyopathy. We report here on a case of child who showed the typical findings of TLVABS in association with pericarditis. He presented with dyspnea and pericardial effusion, which required pericardiocentesis. After pericardiocentesis, he showed the typical echocardiographic and electrocardiographic findings of TLVABS. The MRI findings at 14 days after the initial symptoms showed normal coronary arteries and normal left ventricular function without any wall motion abnormalities. In addition, no delayed hyper enhancement was found on delayed-enhanced (DE)-MRI. We also reviewed the other reported cases of TLVABS in patients who were under the age of 40.

Lupus Myopericarditis as a Preceding Stressor for Takotsubo Cardiomyopathy

“…Of these, at least three cases reported pericarditis preceding the development of TC, while three other reports suggested the possible occurrence of pericarditis in the resolution phase of TC and one report did not specify the onset of pericarditis with respect to TC (8)(9)(10)(11)(12)(13)(14)(15). We believe that our…”

“…Acute pericarditis and Dressler syndrome have been reported as possible complications of TC (9,10). Conversely, acute pericarditis complicated by TC has been reported on at least three occasions (11)(12)(13), where pericarditis was the primary pathology. Systemic lupus erythematosus presenting with myopericarditis and associated with TC as a complication is the fi rst such case reported, to the best of our knowledge.…”

A 6-Year-Old Girl With Undiagnosed Hemophagocytic Lymphohistiocytosis and Takotsubo Cardiomyopathy

“…9 It is unclear whether takotsubo belongs to a spectrum of reversible left ventricular dysfunction that also incorporates neurogenic stunned myocardium or has a unique pathophysiology. 8,[11][12][13][14][15][16][17][18][19][20][21] The proposed mechanism for takotsubo in HLH is excess circulating cytokines, leading to direct myocardial depression and or toxicity. 9,10 Takotsubo cardiomyopathy has been well described in the adult literature.…”

Das Herz und die Psyche

“…Diagnostisch ist dabei das Fehlen einer Koronarobstruktion bei der Herzkatheteruntersuchung (94)(95)(96)(97)(98). Die Erkrankung kommt -wenngleich selten -auch im Kindesalter vor, dazu wurden in den letzten Jahren einzelne Fallberichte publiziert (99)(100)(101). Die zumeist reversible Tako-Tsubo-Kardiomyopathie ist eine relativ neue Erkrankung (Erstdiagnose 1990) und daher derzeit noch möglicherweise unterdiagnostiziert.…”