Extensive myocardial stunning showing transient regression of prolonged T wave inversion and prolonged sympathetic denervation

A 69-year-old woman was admitted to the hospital with palpitations. Althoug h left ventriculography showed extensive akinesis except in the basal hyper kinetic segment, coronary angiography showed normal coronary arteries. I-12 3-metaiodobenzylguanidine (MIBG) accumulation was obviously reduced in the anteroseptal, apical and inferior areas. Inverted T waves developed on day 3 and disappeared on day 104 after transient regression. Echocardiography s howed normal left ventricular motion two weeks later. Ergonovine provocatio n test showed no vasospasm and thallium-201 showed no perfusion defect on d ay 46. Electrocardiography and MIBG returned to normal on day 216. These fi ndings suggest prolonged sympathetic nerve injury in extensive myocardial s tunning.