A case of transient left ventricular apical ballooning syndrome in a child: clinical features and imaging findings

Int J Cardiovasc Imaging. 2010 Dec;26(Suppl 2):345-51. doi: 10.1007/s10554-010-9685-1. Epub 2010 Sep 21.

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 findings 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 findings of TLVABS. The MRI findings 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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Dyspnea / etiology
  • Echocardiography
  • Electrocardiography
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pericardial Effusion
  • Pericardiocentesis
  • Pericarditis / complications
  • Pericarditis / diagnosis*
  • Pericarditis / surgery
  • Radiography, Thoracic
  • Takotsubo Cardiomyopathy / complications
  • Takotsubo Cardiomyopathy / diagnosis*
  • Treatment Outcome