Abstract
Transient left ventricular apical ballooning syndrome is characterized by reversible
left ventricular wall motion abnormalities, chest pain or dyspnea, ST-segment elevation,
and mild elevation of cardiac enzyme levels in the absence of obstructive coronary
artery disease. The pathophysiology of the syndrome is still unknown. The probable
mechanism is supposed to be a catecholamine discharge. We report the case of a 66-year-old
woman with recently diagnosed pheochromocytoma who presented with chest pain and ST-segment
elevation. Coronary angiography revealed normal coronaries and apical dyskinesia at
ventriculography. A similar episode of chest pain occurred 4 years ago with same angiographic
findings and reversible inferobasal akinesia. In-hospital course was uneventful and
the patient was discharged from the hospital 4 days later with treatment of aspirin
1 × 100 mg, metoprolol 1 × 50 mg, lisinopril 1 × 10 mg, and atorvastatin 1 × 20 mg.
At 2 years follow-up after the event, the patient remained asymptomatic.
Keywords
apical ballooning syndrome - pheochromocytoma - catecholamine
