Transient Left Ventricular Apical Ballooning (LVAB) was first described in Japan in the early 1990’s. Since then it has been reported in many countries worldwide. It typically presents after physical or emotional stress with chest pain, ECG changes, positive cardiac markers and marked akinesia of mid to apical left ventricular wall with ballooning appearance despite normal coronaries. The goal of this study was to perform meta-analysis of the published cases in regards to race and gender.
Using pubmed, we searched all published manuscripts relevant to left ventricular apical ballooning syndrome. We included case series and individual case reports in this study. We evaluated the effect of gender and race on the presentation of LVAB using uni and multi-variate analysis.
A total of 185 patient cases were identified that were included in the analysis. Most cases were females, totaling 173 patients (93.5%). Asians and Caucasian were the majority of the reported races. Asians on average were older (70 +/- 9.5 yo vs 64 +/- 12.7 yo), less likely to have; their syndrome precipitated by emotional stress (26.5% vs 51.7%), positive cardiac markers (77.1% vs 97.6%), present with chest pain (55.4% vs 81.0%), or with T wave inversion (67.3% vs 95.8%), but were more likely to have ST elevation on EKG (97.1% vs 83.3%). There were no differences in regards to complications or death.
LVAB is becoming more recognized in different races. While predominantly effecting females, the presentation is similar to men. However, there are significant differences in the presentation of LVAB between Asians and Caucasians.
Clinical presentation of LVAB differs between Caucasians and Asian which needs to be considered in patient presenting with LVAB.
Daniel Donohue, None.