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Transient Left Ventricular Apical Ballooning Syndrome and Cardiac Dysfunction after Subarachnoid Hemorrhage: Similar Clinical Entities?

Universally accepted diagnostic criteria for transient left ventricular apical ballooning syndrome are not yet available and the cardiac dysfunction complicating subarachnoid hemorrhage drops several hints of discussion about the clinical and pathophysiological similarities with the "typical" transient left ventricular apical ballooning syndrome. We suggest that, in the light of clinical and pathophysiological evidences, transient left ventricular apical ballooning syn- drome should no longer be considered an exclusively "apical" myocardial abnormality and this diagnosis should not be excluded in patients experiencing acute brain injury and cerebrovascular events. Each kind of reversible cardiac dysfunc- tion, mediated by the central nervous system and initiated by acute brain injury, both physical, like cerebrovascular acci- dents or head traumas, and psychical, like sudden emotional stress, should be encompassed in a unifying definition with the widest inclusion criteria, such as "Acute Ballooning Cardiomyopathy" (ABC), that is likely to be more representative of the real needs in the clinical setting.