J Rheum Dis.  2014 Apr;21(2):91-95. 10.4078/jrd.2014.21.2.91.

A Case of Persistent Apical Ballooning in a Patient with SLE

• Im HJ
• Lee JH
• Yeo HJ
• Lee HJ
• Byun KS
• Kim MJ

• KMID: 2094664
• DOI: http://doi.org/10.4078/jrd.2014.21.2.91

Abstract

Apical ballooning syndrome (ABS), also referred to as stress cardiomyopathy, is characterized by acute left ventricular dysfunction following a stressful situation. Diagnosis of ABS is made in the following scenarios: transient hypokinesia or dyskinesia of the left ventricular segment, absence of obstructive coronary disease, new electrocardiogram abnormalities, absence of recent significant head trauma, pheochromocytoma, myocarditis, and hypertrophic cardiomyopathy. Prognosis is usually favorable since the wall motion abnormality returns to normal within days, and certainly within the first month. We encountered a case of SLE with apical ballooning on echocardiography in a 44-year-old woman. She was suffering from severe left ventricular dysfunction that has persisted on 5 year follow-up echocardiography. We report this case along with a review of the relevant literature.

Keyword

Systemic lupus erythematosus; Persistent apical ballooning

MeSH Terms

Adult
Cardiomyopathy, Hypertrophic
Coronary Disease
Craniocerebral Trauma
Diagnosis
Dyskinesias
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Humans
Hypokinesia
Lupus Erythematosus, Systemic
Myocarditis
Pheochromocytoma
Prognosis
Takotsubo Cardiomyopathy
Ventricular Dysfunction, Left

Figure

• 

  Figure 1. Electrocardiogram showing persistent ST-segment elevation during the first admission (A) and 5-year Follow-up (B).

• 

  Figure 2. Transthoracic echocardiography during the diastole (A), systole at first admission (B), during the diastole (C), systole (D) after 3-year Follow-up, during the diastole (E), systole (F) after 5-year Follow-up. It shows basal akinesia at mid to inferior wall with persistent apical ballooning.

• 

  Figure 3. Coronary angiogram showed normal right (A) and left (B) coronary arteries.

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