Apical Ballooning Syndrome: Recent Insights from a Consecutive Series of 104 Patients

Abstract

Apical ballooning syndrome (Takotsubo cardiomyopathy) is an increasingly recognized form of acute systolic dysfunction which is usually reversible. It typically occurs in post-menopausal women following a major psychological stressor. We conducted a single center, retrospective analysis of all hospitalized patients from 2001-2012 and found 104 patients who met the diagnostic criteria for apical ballooning. In this current largest series of its kind, 83% of the patients were women. Among both men and women, an antecedent stressor was not always identified. The exact pathophysiologic mechanism resulting in apical ballooning remains poorly understood. These findings challenge the paradigm that catecholamine cardiotoxicity in the setting of relative estrogen deficiency results in the cardiomyopathy.