Effect of Intravenous Propranolol on Left Ventricular Apical Ballooning Without Coronary Artery Stenosis (Ampulla Cardiomyopathy)

Three Cases

Abstract

The precise etiological basis of transient left ventricular apical ballooning without coronary artery stenosis (ampulla or so-called `takotsubo' cardiomyopathy) remains unknown, so the present study examined the acute effects of intravenous propranolol (2-4 mg) in 3 female patients (age range, 61-76 years) with the condition. Although one patient who did not have any intraventricular pressure gradients showed no improvement in the electrocardiographic and left ventricular wall motion abnormalities, the other 2 patients, who had significant intraventricular pressure gradients, did show improvement. Dynamic intraventricular obstruction might play a role in maintaining apical ballooning, at least, in patients exhibiting an intraventricular pressure gradient. (Circ J 2002; 66: 1181 - 1184)