PMID- 18288755
OWN - NLM
STAT- MEDLINE
DCOM- 20080327
LR  - 20231024
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 71
IP  - 3
DP  - 2008 Feb 15
TI  - Transient left ventricular apical ballooning: A unifying pathophysiologic theory 
      at the edge of Prinzmetal angina.
PG  - 342-52
LID - 10.1002/ccd.21338 [doi]
AB  - INTRODUCTION: Takotsubo or ampulla transient left ventricular apical ballooning 
      (LVAB) cardiomyopathy has been described as a clinical syndrome characterized by 
      the sudden onset of chest pain, cardiac failure, ischemic changes on 
      electrocardiography, and apical severe myocardial dysfunction in the presence of 
      "normal" coronary arteries on angiography. All features last from a few days to a 
      few weeks. METHODS AND RESULTS: On the basis of previous knowledge and in light 
      of our recent experience with acetylcholine testing in this condition, the cases 
      of four patients are described and preliminary but sound arguments are given to 
      support the theory that LVAB is caused by severe, sustained spasm of many or all 
      of the coronary vessels. In one of these patients, experimental reproduction of 
      LVAB occurred in the catheterization laboratory during acetylcholine testing (as 
      evidenced by echocardiographic monitoring), while in two other patients, the test 
      provoked similar, extensive angiographic vasospasm and suggestive symptoms. In 
      addition, the similarities and differences that exist between LVAB and Prinzmetal 
      angina are discussed. CONCLUSION: To evaluate the pathogenesis of LVAB, it is 
      proposed that acetylcholine testing be routinely performed under specific, 
      prospective, investigational protocols at specialized centers.
CI  - (c) 2008 Wiley-Liss, Inc.
FAU - Angelini, Paolo
AU  - Angelini P
AD  - Baylor College of Medicine, Texas Heart Institute at St. Luke's Episcopal 
      Hospital, Houston, Texas, USA. pangelinimd@houston.rr.com
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Aged, 80 and over
MH  - Angina Pectoris, Variant/*diagnosis/physiopathology
MH  - Cardiac Catheterization/methods
MH  - Coronary Angiography/methods
MH  - Diagnosis, Differential
MH  - Echocardiography, Doppler
MH  - Electrocardiography
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Radionuclide Angiography/methods
MH  - Radionuclide Ventriculography/methods
MH  - Recurrence
MH  - Remission, Spontaneous
MH  - Sampling Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Takotsubo Cardiomyopathy/*diagnosis/physiopathology
MH  - Ventricular Dysfunction, Left/*diagnosis/physiopathology
EDAT- 2008/02/22 09:00
MHDA- 2008/03/28 09:00
CRDT- 2008/02/22 09:00
PHST- 2008/02/22 09:00 [pubmed]
PHST- 2008/03/28 09:00 [medline]
PHST- 2008/02/22 09:00 [entrez]
AID - 10.1002/ccd.21338 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2008 Feb 15;71(3):342-52. doi: 10.1002/ccd.21338.