The author reviews the pathophysiology, clinical features, management, complications, and prognosis of apical ballooning. Three case reports are included to illustrate the growing experience with this abnormality.

Transient left ventricular apical ballooning, also known as takotsubo cardiomyopathy, is an unusual abnormality that may be the underlying cause of signs and symptoms of acute myocardial infarction (AMI) in a small number of patients. The signs and symptoms include chest pain, ST-segment changes, and the release of cardiac biomarkers.1 Dyspnea and hypotension may also occur. Although these signs and symptoms are suggestive of AMI, they are not caused by ischemic coronary artery disease. This abrupt onset of extensive “ballooning” or dilatation of the left ventricle occurs most often in postmenopausal women after a traumatic psychosocial or physical stressor.1 

Although its onset is sudden and dramatic, apical ballooning is transient and reversible. Its cause is not known. It is increasingly recognized...

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