Transient left ventricular apical ballooning syndrome is a unique, reversible cardiomyopathy usually found in postmenopausal women, presenting with evolutional electrocardiographic changes and elevated cardiac biomarkers suggestive of acute ST-segment elevation myocardial infarction without angiographic coronary artery stenosis. We present a 62-year-old diabetic female with typical pictures of transient left ventricular apical ballooning syndrome. Acute anterior myocardial infarction was diagnosed initially based on the marked
electrocardiographic changes and elevated troponin. However, coronary angiography showed no significant stenosis. ST-segment elevation of the electrocardiogram returned to baseline with development of T-wave inversion about one week later. We used three-dimensional images by dual-source multidetector computed tomography to well demonstrate the unique, reversible change of the left ventricle. The patient had a good recovery under supportive therapy. Transient left ventricular apical ballooning syndrome is an important differential diagnosis of acute coronary syndrome.