Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging
Open Access
- 20 May 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal
- Vol. 29 (21), 2651-2659
- https://doi.org/10.1093/eurheartj/ehn433
Abstract
The apical ballooning syndrome (ABS) is a new diagnostic entity which is increasingly recognized. Precise magnetic resonance imaging (MRI) data are not yet available and there is little evidence for the differential diagnosis of ABS assessed by MRI. Between January 2005 and January 2008, 6100 consecutive patients with diagnosis of acute coronary syndrome underwent left heart catheterization. In 59 patients (1.0%), coronary angiography revealed normal coronary arteries, but left ventriculography showed left ventricular dysfunction with apical ballooning. These 59 patients underwent cardiac MRI using a 1.5 T MRI scanner. In 13 patients (22.0%), MRI revealed diagnosis of myocardial infarction, in eight patients (13.6%) diagnosis of myocarditis. In all other 38 (64.4%) patients (36 female, age 73 ± 10 years) with suspected ABS, no delayed enhancement or signs of inflammation were detected. Follow-up MRI after 3 months showed a completely normalized left ventricular ejection in all patients with suspected ABS. Similarly, the end-diastolic volume and end-systolic volume improved at follow-up. Cardiac MRI allows differentiating ABS from other rare causes with unobstructed coronary vessels such as myocarditis and coronary emboli with spontaneous lysis. Therefore, cardiac MRI can add valuable information in all patients with suspected ABS for further differential diagnosis.Keywords
This publication has 37 references indexed in Scilit:
- Tako-tsubo cardiomyopathy (apical ballooning)Heart, 2007
- Four-Year Recurrence Rate and Prognosis of the Apical Ballooning SyndromeJournal of the American College of Cardiology, 2007
- Transient Midventricular Ballooning SyndromeJournal of the American College of Cardiology, 2006
- Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic reviewEuropean Heart Journal, 2006
- Reproducibility of Chronic and Acute Infarct Size Measurement by Delayed Enhancement-Magnetic Resonance ImagingJournal of the American College of Cardiology, 2006
- Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathiesEuropean Heart Journal, 2005
- Prayer for Health ConcernsArchives of Internal Medicine, 2004
- The Use of Contrast-Enhanced Magnetic Resonance Imaging to Identify Reversible Myocardial DysfunctionNew England Journal of Medicine, 2000
- "Black blood" T2-weighted inversion-recovery MR imaging of the heart.Radiology, 1996
- Analysis of myocardial oedema by magnetic resonance imaging early after coronary artery occlusion with or without reperfusionCardiovascular Research, 1993