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Int J Cardiovasc Imaging (2010) 26:345351 DOI 10.1007/s10554-010-9685-1
ORIGINAL PAPER
A case of transient left ventricular apical ballooning syndrome in a child: clinical features and imaging ndings
So Young Lee Se Eun Lee Jong Woon Choi
Sang Il Choi Eun Ju Chun Jung Yun Choi
Received: 10 August 2010 / Accepted: 11 August 2010 / Published online: 21 September 2010 Springer Science+Business Media, B.V. 2010
Abstract Transient left ventricular apical ballooning syndrome (TLVABS) is an acute cardiac disease that is characterized by transient left ventricular systolic dysfunction involving the apical region. The symptoms and electrocardiographic changes of TLVABS mimic those observed in acute myocardial infarction while obstructive coronary arterial lesions are not seen in patients with TLVABS. TLVABS usually occurs in elderly women after physical or emotional stress. However, it is very rare in children and so it not well known to pediatricians. Accordingly, TLVABS in children can be misdiagnosed as myocarditis or cardiomyopathy. We report here on a case of child who showed the typical ndings of TLVABS in association with pericarditis. He presented with dyspnea and pericardial effusion, which required pericardiocentesis. After pericardiocentesis, he showed the typical echocardiographic and electrocardiographic ndings of TLVABS. The MRI
ndings at 14 days after the initial symptoms showed normal coronary arteries and normal left ventricular function without any wall motion abnormalities. In addition, no delayed hyper enhancement was found on delayed-enhanced (DE)-MRI. We also reviewed the other reported cases of TLVABS in patients who were under the age of 40.
Keywords Takotsubo cardiomyopathy
Pericarditis Child
Introduction
Transient left ventricular apical ballooning syndrome (TLVABS) is also called takotsubo cardiomyopathy or stress-induced cardiomyopathy, and this is an acute cardiac disease of an unknown etiology. It is characterized by transient left ventricular systolic dysfunction, i.e., ballooning of the left ventricular apex in the systolic phase due to apical akinesia. The disease was rst described by Dote et al. [2] in 1991 and it was named after the Japanese octopus trap, called takotsubo, due to the shape of the left ventricle in the systolic phase [6].
The clinical features of TLVABS are similar to those of anterior acute myocardial infarction except that coronary angiography fails to detect a signicant obstructive lesion. Moreover, in almost all patients with TLVABS, the left ventricular...