Transient left ventricular apical ballooning and cardiac magnetic resonance

Cardiovascular magnetic resonance findings in typical versus atypical forms of the acute apical ballooning syndrome (Takotsubo cardiomyopathy)

“…So far only two other cases of delayed hyperenhancement in TTC have been reported [6,20]. In both cases the hyperenhanced area was small compared to the extent of WMA.…”

“…However, clinical experience with CMR in this entity is still limited. CMR findings have been reported in studies by Sharkey et al [6] (n = 22 patients), Wittstein et al [7] (n = 5 patients), Haghi et al [5] (n = 4 patients with variant form of TTC), and in several case reports [8][9][10]13,20,21]. Sharkey et al [6] were the first to report CMR data on all their study patients.…”

Magnetic resonance reveals long-term sequelae of apical ballooning syndrome

“…Although clinical experience with CMR in this entity is still limited, our findings contrast with previous reports, which showed preserved myocardium in almost all cases. So far, only 3 cases of delayed hyperenhancement have been reported [10][11][12][13].…”

“…Contrast enhanced cardiac magnetic resonance (ce-CMR) has emerged as a uniquely precise technique for the characterization of myocardial necrosis or fibrosis, not only in ischemic heart disease but also in non-ischemic cardiomyopathies [8,9]. Although earlier experience with this technique in a limited number of patients with ABS has mostly shown preserved myocardium, cases with focal delayed hyperenhancement demonstrating irreversible damage have been reported sporadically [10][11][12][13]. In most cases the observed size of the delayed hyperenhancement was small in relation to the extent of wall motion abnormalities [13].…”

Gadolinium enhanced MRI in patients with left ventricular apical ballooning syndrome implicates myocarditis as an etiology

“…It has been used to evaluate infarct size, detect viable myocardium, detect inflammatory change in transplanted hearts, and to diagnose and follow progression of myocarditis. CMR has also been used to assess the recovery and guide management of a patients with LVABS [12,22,23].…”