Stress cardiomyopathy: transient basal ballooning

Abstract

Stress cardiomyopathy is a reversible left ventricular dysfunction triggered by emotional stress. We describe a variant of transient left ventricular ballooning in a patient in which basal and midventricular segments are affected. This confirms that there is not just one ventricular dysfunction pattern in Takotsubo cardiomyopathy. The involvement of only the basal and midventricle segments is an intriguing observation with no clear explanation; furthermore, there are no predictive factors for the differently sited wall motion abnormalities.

Takotsubo syndrome: aetiology, presentation and treatment

“…Four different patterns of TTS have previously been reported (figure 4). Although apical ballooning is the classic and most common type (80%), variant forms such as midventricular51 and basal type52 have been demonstrated. The midventricular type has been shown to be present in approximately 4%–40% of patients with TTS 47 53–56.…”

Prevalence and Clinical Features of Focal Takotsubo Cardiomyopathy

“…akotsubo cardiomyopathy is classically described as apical ballooning, 1 but other types of takotsubo cardiomyopathy, such as mid-ventricular 2 and basal ballooning, 3 have been demonstrated. Several case reports have shown focal takotsubo cardiomyopathy.…”

Focal mid-ventricular anterior ballooning: An unusual pattern of Takotsubo cardiomyopathy

“…Several novel variants of TC have been described recently; however, "typical" TC remains the pattern observed most frequently. Atypical forms are associated with distinct regional left ventricular wall motion abnormalities, although reverse or inverted TC, midventricular type and biventricular (right and left ventricular) ballooning group have also been described (2)(3)(4). In reverse or inverted TC, the apex is hyperdynamic and the base is akinetic (2).…”

“…Diagnoses of TC are becoming more common, likely due to an increase in the awareness of interactions between critical brain activity and the heart. The most common presentation of TC is an apical ballooning pattern; however, several recent case reports have described variants of TC that present with differing patterns (2)(3)(4). These atypical forms are associated with distinct regional left ventricular wall motion abnormalities.…”