Transient increase in wall thickness of the left ventricular apex during recovery from “ampulla” cardiomyopathy

Abstract

"Ampulla" cardiomyopathy is a syndrome characterized by transient abnormal left ventricular wall motion with hypokinesia around the apical area and hyperkinesia at the basal area, without any detectable coronary lesion. Two cases of transient wall thickening of the left ventricular apex during recovery from "ampulla" cardiomyopathy are described. Apical wall thickening was documented by left ventriculography, echocardiography, and thallium (201Tl) single-photon emission computed tomography (SPECT) during the recovery phase. The thickness of the apical wall subsequently returned to normal. Both patients underwent provocation tests. Coronary spasms were positive. This transient increase in left ventricular apical volume may have been caused by myocardial inflammation secondary to "ampulla" cardiomyopathy.

Transient apical wall thickening in patients with stress cardiomyopathy: Prevalence, profile, and impact on clinical course

“…We have observed this finding in several patients with SCM during recovery. There have also been several case reports regarding this phenomenon [9][10][11][12]; however, the incidence and clinical significance of this finding had not been studied. The results Data are expressed as number (%) or mean ± standard deviation.…”

“…Although reports on SCM are increasing, the nature of SCM remains ill-defined. Recently, transient apical wall thickening (TAWT), which mimics apical hypertrophic cardiomyopathy during recovery from SCM, has been reported [9][10][11][12]. This phenomenon developed during recovery of SCM patients who showed a marked increase in LV apical wall thickness that subsequently resolved [9][10][11][12].…”

A case of transient apical hypertrophy associated with coronary vasospasm

“…In contrast, apical wall thickness gradually increased, and apical hypertrophy appeared over a few weeks to months. Subsequently, the apical wall thickness gradually decreased and returned to normal thickness over a few months to a year [1][2][3][4]. In this case, the left ventricular wall motion abnormalities improved on day 3, and apical hypertrophy appeared on day 20, and returned to normal on day 51.…”

“…A case of transient apical hypertrophy associated with coronary vasospasm is rare. Few clinical cases have reported transient apical hypertrophy following takotsubo cardiomyopathy and acute myocarditis in addition to coronary vasospasm [1][2][3][4].…”