Apical Ballooning Syndrome: The Broken Heart Syndrome

Four case studies of apical ballooning syndrome are reported to demonstrate the typical presentation, specific cardiac imaging, and clinical outcomes. Most patients are women and present with symptoms of acute coronary syndrome precipitated by emotional distress or physical stressors. Electrocardiograms (ECGs) may vary from nonspecific ST-T changes to full-blown manifestations of ST segment elevation infarct. Cardiac markers demonstrate minimal or moderate elevations. Basal hypercontractility and apical ballooning are classical cardiac imaging and coronary arteries are usually normal. Patients are expected to have an uneventful hospital course and complete left ventricular function recovery, and most patients do not have any recurrences.