Effect of intravenous propranolol on left ventricular apical ballooning without coronary artery stenosis (ampulla cardiomyopathy): three cases.

The precise etiological basis of transient left ventricular apical ballooning without coronary artery stenosis (ampulla or so-called 'takotsubo' cardiomyopathy) remains unknown, so the present study examined the acute effects of intravenous propranolol (2-4 mg) in 3 female patients (age range, 61-76 years) with the condition. Although one patient who did not have any intraventricular pressure gradients showed no improvement in the electrocardiographic and left ventricular wall motion abnormalities, the other 2 patients, who had significant intraventricular pressure gradients, did show improvement. Dynamic intraventricular obstruction might play a role in maintaining apical ballooning, at least, in patients exhibiting an intraventricular pressure gradient.