Table 1

Findings in 13 white patients with “apical ballooning”

Patient number
CK, creatine kinase; CVA, cerebrovascular accident; F, female; IABP, intra-aortic balloon pump; IPG, intraventricular pressure gradient; LBBB, left bundle branch block; LVEDP, left ventricle end diastolic pressure; M, male; NA, not available; NYHA, New York Heart Association functional class at discharge; PCWP, pulmonary capillary wedge pressure; TTE, transthoracic echocardiography; VF, ventricular fibrillation.
Age (years)81786571486652484566576069
Presenting symptomChest painST ↑on monitorChest pain, vomitusChest pain, dyspnoeaChest pain, shockChest pain, vomitusCVA, fallDyspnoea, coughVFChest painRespiratory distressChest pain, dyspnoeaChest pain, dyspnoea, nausea
Duration before admission (h)24054652NA036NA726
Symptoms before TTE (h)2467224161148685024481868
Symptoms before angiography (h)262166.5101912722.6273243
Precipitating factorUnknownTrauma (rib fractures)Emotional stress (death of husband)UnknownEmotional stressUnknownCVAAsthma crisisUnknownExerciseAspiration pneumoniaEmotional stress (minor car accident)Exercise
Admission ECGNormalNormalNormalNegative T V1 – V6, ST ↑V1 – V4Slow R progression anterior, ST ↑V1 – V6LBBB (new)NormalNormalNegative T II, III, aVFNegative T I, II, aVL, aVF, V3 – V6ST ↑I, II, aVF, V2 – V6ST ↑I, aVLDiscrete ST ↑II, III, aVF, V2 – V6
ECG on day 115 min later, broad QRS after resuscutation12 h later, negative T V1 – V6, ST ↑V2 – V6NormalUnchanged4 h later, ST ↑more pronounced8 h later, negative T V4 – V6, aVL12 h later, ST increase 1 mm and negative T V2 – V648 h later, negative T V2 – V6, II, III, aVFNegative T I, III, aVF, V3, V68 h later unchangedST ↑II, aVL, negative T I, aVL, V2 – V6ST ↑I, aVL, negative T I, aVL, V2 – V6NA
ECG on day 2Negative T V2 – V6, I, II, III, aVF, ST ↑0.5 mm III, aVFUnchangedNegative T V3 – V6UnchangedNegative T V3 – V6, II, III, aVF, ST ↑V3 – V5UnchangedDeep negative T anterior, I, II, aVL, aVFUnchangedNegative T V2 – V6 more pronounced, negative T II, aVFNegative T V3 – V6ST ↑II, aVL, negative T I, aVL, V2 – V6Negative T I, aVL, V2 – V6 more pronouncedNA
ECG follow upNANegative TNegative TNormalNormalNormalNegative TNegative TNegative TNegative T aVLFlattened T wavesSlightly negative T I, aVL, V3 – V6Normal
Pathological Q wavesV1 – V3AnteriorAbsentAbsentAbsentAbsentV1 – V3V1 – V3AbsentAbsentAbsentAbsentAbsent
QTc (ms)460428674466522441310434400469436406409
Admission CK MB (μ g/ ml)NANA16.610.916.2NA55.24.711.840.512.412.1
Maximum CK MB (μ g/ ml)34.932.516.610.916.24217.55.26.311.8115.734.512.1
Admission troponin I (μ g/ ml)10.113.417.817.319.4NA1.9<
Maximum troponin I (μ g/ ml)97.616.917.817.319.4NA12.
IPG (mm Hg)000009000079000
LVEDP (mm Hg)20352024341842242834302022
Cardiac index1.7NANANA1.31.7NANA2.2NA2.2NANA
IABP (days)5NoneNoneNone44NoneNone525NoneNone
Time to recuperation (days)NA91418121414351246261515