Table of Contents
ISRN Vascular Medicine
Volume 2012, Article ID 478536, 6 pages
Review Article

Transient Left Ventricular Apical Ballooning in a Postmenopausal Woman with Chronic Liver Disease, Malignancy, and Recent Ischemic Stroke: A Case Report and Review of the Literature

1Ross University School of Medicine, 630 US Highway 1, North Brunswick, NJ 08902, USA
2Department of Medicine, St. Mary’s Hospital, 56 Franklin Street, Waterbury, CT 06706, USA

Received 29 September 2012; Accepted 29 October 2012

Academic Editors: M. Aschermann and M. R. Prince

Copyright © 2012 Dustin Covell and Nathan Clendenen. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Transient left ventricular apical ballooning (TLVAB), or Takotsubo cardiomyopathy, is a poorly understood phenomenon that is thought to be related to a surge of catecholamines under stress conditions that causes microvascular dysfunction and a unique pattern of myocardial stunning. TLVAB occurs in two distinct patient populations: (i) community presentation similar to acute coronary syndrome and (ii) the critically ill. Understanding the differences in presentation, prognosis and management between these two groups may improve the outcome. We present a case of TLVAB developing in a Caucasian postmenopausal female who developed TLVAB suddenly on a background of chronic liver disease, malignancy, and recent ischemic stroke. The patient presented with hemodynamic collapse and was treated with inotropes, vasopressors, and supportive care until cardiac function improved. Additionally, we review the current literature describing the risk factors, pathophysiology, and treatment of TLVAB.