Key result
Two cases of atypical transient cardiomyopathy with mid-ventricular ballooning demonstrated complete recovery of left ventricular function within 1 to 2 months.
Case Report (n=2)
No
Atypical mid-ventricular ballooning can mimic acute myocardial infarction and requires serial non-invasive imaging and laboratory evaluation to differentiate from viral myocarditis.
May support expectant management with serial imaging in suspected cases; hypothesis-generating and leaves open need for larger validation studies.
Apical ballooning cardiomyopathy (Takotsubo or ampulla cardiomyopathy) is a well-known transient and localized left ventricular (LV) dysfunction characterized by apical severe hypokinesis, typical electrocardiogram (ECG) changes of negative T, and a lack of organic lesions of the coronary arteries which could cause myocardial ischemia leading to segmental asynergy. Here we report on two cases of transient cardiomyopathy showing atypically localized asynergy, which is different from Takotsubo cardiomyopathy. Case 1 was diagnosed as atypical Takotsubo cardiomyopathy, and the current findings suggest case 2 was viral myocarditis. These cases suggest that there exist variant patterns of transient cardiomyopathy, and non-invasive and serial clinical evaluations are important for differential diagnosis in acute and atypical cardiomyopathy.
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Kureishi et al. (2006) conducted a case report in Atypical acute ballooning cardiomyopathy (n=2). Atypical transient cardiomyopathy (mid-ventricular ballooning) was evaluated on Recovery of left ventricular function and normalization of ECG. Two cases of atypical transient cardiomyopathy with mid-ventricular ballooning demonstrated complete recovery of left ventricular function within 1 to 2 months.
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