Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy

Ranjini Raina Roy, Fayaz A. Hakim, R. Todd Hurst, David Simper, Christopher P. Appleton

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apicalvariant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)179-183
Number of pages5
JournalTexas Heart Institute Journal
Volume41
Issue number2
DOIs
StatePublished - Apr 2014

Keywords

  • Cardiomyopathy
  • Heart ventricles/physiopathology
  • Hypertrophic/complications/diagnosis
  • Left
  • Takotsubo cardiomyopathy/diagnosis/physiopathology
  • Time factors
  • Ventricular dysfunction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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