Journal List > J Rheum Dis > v.21(2) > 1064170

J Rheum Dis. 2014 Apr;21(2):91-95. Korean.
Published online April 30, 2014.
Copyright © 2014 by The Korean College of Rheumatology
A Case of Persistent Apical Ballooning in a Patient with SLE
Ho Joon Im, Ji Hyun Lee, Hyun Jung Yeo, Hong Jik Lee, Ki Sup Byun and Min Jung Kim
Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea.

Corresponding to: Ji Hyun Lee, Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, 4-12, Daechung-dong, Jung-gu, Busan 600-730, Korea. Email:
Received April 19, 2013; Revised June 19, 2013; Accepted June 19, 2013.

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.


Apical ballooning syndrome (ABS), also referred to as stress cardiomyopathy, is characterized by acute left ventricular dysfunction following a stressful situation. Diagnosis of ABS is made in the following scenarios: transient hypokinesia or dyskinesia of the left ventricular segment, absence of obstructive coronary disease, new electrocardiogram abnormalities, absence of recent significant head trauma, pheochromocytoma, myocarditis, and hypertrophic cardiomyopathy. Prognosis is usually favorable since the wall motion abnormality returns to normal within days, and certainly within the first month. We encountered a case of SLE with apical ballooning on echocardiography in a 44-year-old woman. She was suffering from severe left ventricular dysfunction that has persisted on 5 year follow-up echocardiography. We report this case along with a review of the relevant literature.

Keywords: Systemic lupus erythematosus; Persistent apical ballooning


Figure 1
Electrocardiogram showing persistent ST-segment elevation during the first admission (A) and 5-year Follow-up (B).
Click for larger image

Figure 2
Transthoracic echocardiography during the diastole (A), systole at first admission (B), during the diastole (C), systole (D) after 3-year Follow-up, during the diastole (E), systole (F) after 5-year Follow-up. It shows basal akinesia at mid to inferior wall with persistent apical ballooning.
Click for larger image

Figure 3
Coronary angiogram showed normal right (A) and left (B) coronary arteries.
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