Causes of Apical Ballooning Syndrome

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Apical ballooning syndrome is a reversible cardiomypathy that presents itself just like a myocardial infarction, according to the U.S. National Library of Medicine at the National Institutes of Health. It is important to understand the causes of this condition so that you can know your risk of the potentially serious episode.
Apical ballooning syndrome occurs when the myocardium, or heart muscle, suddenly and temporarily weakens. It can cause chest pain, congestive heart failure, and ventricular arrhythmias. It is sometimes referred to as broken heart syndrome because a stressful situation can trigger its onset. An extremely emotional event is usually found right before its occurrence. This may include a death in the family or an emotional breakup. The loss of a job, financial problems or other very emotional events can also be risk factors for such a condition.
The exact cause of apical ballooning syndrome is not known, but there are various theories about what may play a part. It may be one or a combination of these that can cause it. Transient Vasospasm was originally thought to play a part. Coronary arteries may spasm, stealing the blood flow necessary for the heart. The myocardium would then malfunction as a result. Because vasospasms do not occur with direct correlation to the episodes, this is less likely to be the cause than it was once believed.
Some individuals have an anatomical variant called a wraparound left anterior descending artery. This has been associated with apical ballooning syndrome. In most people, this artery typically is the blood supplier for the left ventricle’s anterior wall. Those with the variant have an artery that wraps around the heart’s apex. In these people, the artery also gives blood to the inferior wall of the heart as well as the apex. There has been some correlation between this variant and apical ballooning syndrome, however it is not direct enough to make it a definitive cause.
Microvascular dysfunction is thought by many researchers to play a role in apical ballooning syndrome. The theory suggests that the coronary arteries are malfunctioning at a level that cannot be seen by an angiography. The myocardium does not get the oxygen that it needs.
A fourth theory is that of mid-ventricular obstruction and apical stunning. This describes a thickening of the mid-ventricular wall that can lead to blockage of the normal flow of blood.
Different risk factors make one more likely to experience apical ballooning syndrome. Women who have undergone menopause may be more likely to experience this condition, for instance.
It is important for researchers to understand the causes of apical ballooning syndrome so that steps can be taken to prevent them. More research continues on this subject.