[Mortality due to heart involvement in the catastrophic antiphospholipid syndrome]. / Mortalidad por afectación cardiaca en el síndrome antifosfolípido catastrófico.

Catastrophic antiphospolipid syndrome (CAPS) is extremely rare antiphospolipid syndrome (APS) variety associated to higher mortality. When heart involvement appears has worsening pronostic. We reported a CAPS case, possibily afterward sting wasp triggering, with acute heart failure during evolution. The patient died despite angiographic stents, anticoagulation, corticoids and plasmaphereses treatment carried out.

[Takotsubo cardiomyopathy: transient apical dysfunction of the left ventricle]. / Cardiomiopatía de Takotsubo: disfunción transitoria apical de ventrículo izquierdo.

Transient apical dysfunction syndrome, ballooning or Takotsubo cardiomyopathy is a recently described syndrome. It is a disease with a partially known mechanism, characterized by the morphology adopted by the left ventricle secondary to hypokinesis and dyskinesis of the apical segments and hypercontractibility of the basal segments. In most of the cases published, it is a syndrome with ST segment elevation in the precordial leads, whose presentation form is also thoracic pain or dyspnea, with the possible existence of moderate elevation of cardiac biomarkers. On the contrary to the acute coronary syndrome, patients with left ventricle dysfunction do not have atherothrombotic disease in the coronary arteries. Furthermore, the alterations described have a reversible character. Some diagnostic clinical criteria have been proposed and there is presently some controversy on them and on the complementary examination needed to diagnose it.

["Aborted" Ballooning syndrome]. / Síndrome de Ballooning "abortado".

We describe a patient with previous transient left ventricular apical balloonig three months ago, who had got a new chest ischemic-like pain associated to an important dynamic left ventricular intracavitary obstruction which disappeared after betablockers treatment.