Discinesia medioventricular izquierda transitoria: aspectos clínicos de una nueva variante

We report five consecutive patients with transient midventricular dyskinesia, a recently described variant of transient apical dyskinesia. It is a syndrome that shares a broad clinical, prognostic and, probably, pathogenetic resemblance to the latter. The patients, the majority of whom were experiencing an episode of emotional or physical stress, were all admitted to an emergency department with a clinical presentation compatible with acute myocardial infarction. Evidence of dyskinesia or akinesia in midventricular segments was seen on ventriculography. These ventricular abnormalities resolved completely over a short period of time. No coronary artery abnormality was evident in any patient. The existence of this variant shows that segments other than apical ventricular segments, which are affected in tako-tsubo syndrome, can also undergo reversible change. The occurrence of new variants raises further questions about the relationship between the nervous system, catecholamines and reversible myocardial lesions.