Table 1.
Findings in 13 white patients with “apical ballooning”
| Patient number | |||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | |
| Sex | F | F | F | F | F | F | F | F | F | F | M | F | F |
| Age (years) | 81 | 78 | 65 | 71 | 48 | 66 | 52 | 48 | 45 | 66 | 57 | 60 | 69 |
| Presenting symptom | Chest pain | ST ↑on monitor | Chest pain, vomitus | Chest pain, dyspnoea | Chest pain, shock | Chest pain, vomitus | CVA, fall | Dyspnoea, cough | VF | Chest pain | Respiratory distress | Chest pain, dyspnoea | Chest pain, dyspnoea, nausea |
| Duration before admission (h) | 24 | 0 | 5 | 4 | 6 | 5 | 2 | NA | 0 | 36 | NA | 7 | 26 |
| Symptoms before TTE (h) | 24 | 6 | 72 | 24 | 16 | 11 | 48 | 68 | 50 | 24 | 48 | 18 | 68 |
| Symptoms before angiography (h) | 26 | 2 | 16 | 6.5 | 10 | 19 | 12 | 72 | 2.6 | 27 | 3 | 24 | 3 |
| Precipitating factor | Unknown | Trauma (rib fractures) | Emotional stress (death of husband) | Unknown | Emotional stress | Unknown | CVA | Asthma crisis | Unknown | Exercise | Aspiration pneumonia | Emotional stress (minor car accident) | Exercise |
| Admission ECG | Normal | Normal | Normal | Negative T V1 – V6, ST ↑V1 – V4 | Slow R progression anterior, ST ↑V1 – V6 | LBBB (new) | Normal | Normal | Negative T II, III, aVF | Negative T I, II, aVL, aVF, V3 – V6 | ST ↑I, II, aVF, V2 – V6 | ST ↑I, aVL | Discrete ST ↑II, III, aVF, V2 – V6 |
| ECG on day 1 | 15 min later, broad QRS after resuscutation | 12 h later, negative T V1 – V6, ST ↑V2 – V6 | Normal | Unchanged | 4 h later, ST ↑more pronounced | 8 h later, negative T V4 – V6, aVL | 12 h later, ST increase 1 mm and negative T V2 – V6 | 48 h later, negative T V2 – V6, II, III, aVF | Negative T I, III, aVF, V3, V6 | 8 h later unchanged | ST ↑II, aVL, negative T I, aVL, V2 – V6 | ST ↑I, aVL, negative T I, aVL, V2 – V6 | NA |
| ECG on day 2 | Negative T V2 – V6, I, II, III, aVF, ST ↑0.5 mm III, aVF | Unchanged | Negative T V3 – V6 | Unchanged | Negative T V3 – V6, II, III, aVF, ST ↑V3 – V5 | Unchanged | Deep negative T anterior, I, II, aVL, aVF | Unchanged | Negative T V2 – V6 more pronounced, negative T II, aVF | Negative T V3 – V6 | ST ↑II, aVL, negative T I, aVL, V2 – V6 | Negative T I, aVL, V2 – V6 more pronounced | NA |
| ECG follow up | NA | Negative T | Negative T | Normal | Normal | Normal | Negative T | Negative T | Negative T | Negative T aVL | Flattened T waves | Slightly negative T I, aVL, V3 – V6 | Normal |
| Pathological Q waves | V1 – V3 | Anterior | Absent | Absent | Absent | Absent | V1 – V3 | V1 – V3 | Absent | Absent | Absent | Absent | Absent |
| QTc (ms) | 460 | 428 | 674 | 466 | 522 | 441 | 310 | 434 | 400 | 469 | 436 | 406 | 409 |
| Admission CK MB (μ g/ ml) | NA | NA | 16.6 | 10.9 | 16.2 | NA | 5 | 5.2 | 4.7 | 11.8 | 40.5 | 12.4 | 12.1 |
| Maximum CK MB (μ g/ ml) | 34.9 | 32.5 | 16.6 | 10.9 | 16.2 | 42 | 17.5 | 5.2 | 6.3 | 11.8 | 115.7 | 34.5 | 12.1 |
| Admission troponin I (μ g/ ml) | 10.1 | 13.4 | 17.8 | 17.3 | 19.4 | NA | 1.9 | <0.12 | 3.4 | 5.7 | 14.0 | 2.2 | 3.6 |
| Maximum troponin I (μ g/ ml) | 97.6 | 16.9 | 17.8 | 17.3 | 19.4 | NA | 12.1 | 2.0 | 3.4 | 5.7 | 23.2 | 5.6 | 3.6 |
| IPG (mm Hg) | 0 | 0 | 0 | 0 | 0 | 90 | 0 | 0 | 0 | 79 | 0 | 0 | 0 |
| LVEDP (mm Hg) | 20 | 35 | 20 | 24 | 34 | 18 | 42 | 24 | 28 | 34 | 30 | 20 | 22 |
| Cardiac index | 1.7 | NA | NA | NA | 1.3 | 1.7 | NA | NA | 2.2 | NA | 2.2 | NA | NA |
| PCWP (mm Hg) | 9 | NA | NA | NA | 8 | 16 | NA | NA | 18 | NA | 23 | NA | NA |
| IABP (days) | 5 | None | None | None | 4 | 4 | None | None | 5 | 2 | 5 | None | None |
| Endomyocardial biopsy | NA | NA | NA | NA | Normal | NA | NA | NA | NA | NA | NA | NA | NA |
| NYHA | NA | II | I | I | I | II | II | I | I | II | II | I | II |
| Time to recuperation (days) | NA | 9 | 14 | 18 | 12 | 14 | 14 | 35 | 12 | 46 | 26 | 15 | 15 |
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.