Variant form of the acute apical ballooning syndrome (takotsubo cardiomyopathy): observations on a novel entity

Table 1 Patients' characteristics Characteristic Patient number 1 2 3 4 Age (years) 55 51 41 77 Sex Female Female Female Male Chest pain No Yes Yes Yes ECG abnormalities (leads) ST elevation aVR, aVL V2, V3 No No ST depression II, III, aVF, V3-V6 No V2, V3, V4 V5, V6 T wave inversion aVR, aVL, V2 No No II, III, aVF, V5, V6 QT prolongation Max QTc = 511 ms No Max QTc = 493 ms No Peak creatine kinase (U/l) (normal range 0-145) 550 260 275 154 Peak troponin I (μg/l) (normal range 0-0.4) 21.2 1.85 2.63 1.55 C reactive protein (mg/l) (normal range 0-5) 1 1 7 2 Leucocyte count (x109/l) (normal range 3.6-11.0) 10.5 8.2 12.6 11.0 Left ventricular WMA Basal Anterolateral Basal Posterobasal Mid-portion Diaphragm Mid-portion Posterolateral Triggering factor Colonoscopy Stressful job Neck pain Unknown Max, maximum; WMA, wall motion abnormalities. Delayed hyperenhancement on gadolinium enhanced CMR, which is seen in up to 88% of patients with myocarditis, 3 was absent in all patients. [...]focal myocarditis appears unlikely to be the underlying mechanism.