Author + information
- Received October 2, 2009
- Accepted October 8, 2009
- Published online March 2, 2010.
A 37-year-old woman was transferred with hypotension after sudden chest oppression associated with emotional stress. The electrocardiogram showed ST-segment elevation in the whole lead except aVR, and troponin T was positive. Therefore, she received emergent catheterization for acute coronary syndrome. Initial coronary angiography revealed severe vessel spasm in all coronaries (A, Online Videos 1and 2). After intracoronary nitroglycerin administration, all coronary arteries normalized (B, Online Videos 3and 4), and ST-segment elevation also returned to baseline. However, typical apical ballooning and mid-ventricular wall motion abnormality in end-systolic phase of left ventriculography remained (C and D, Online Video 5). Echocardiography 6 months later demonstrated normalization of left ventricular wall motion. The clinical features of the apical ballooning syndrome (Takotsubo cardiomyopathy) is acute heart failure, sometimes critical, but the etiology has not been clarified. The current typical case was able to document global coronary spasm, which might explain the cause of this syndrome.
- Received October 2, 2009.
- Accepted October 8, 2009.
- American College of Cardiology Foundation