Key result
A 36-year-old breastfeeding woman with spontaneous coronary artery dissection and possible takotsubo syndrome initially managed conservatively required percutaneous coronary intervention after a recurrent myocardial infarction.
Why the study?
The relationship between spontaneous coronary artery dissection and takotsubo syndrome remains unclear despite reports of their coexistence.
Case Report (n=1)
No
This case highlights the potential coexistence of SCAD and takotsubo syndrome, suggesting that patients with SCAD may require close monitoring and potentially invasive treatment.
Suspected SCAD-takotsubo overlap may warrant close monitoring; single case leaves optimal strategy open for larger studies.
RATIONALE: The relationship between spontaneous coronary artery dissection (SCAD) and takotsubo syndrome (TTS) remains unclear. Coexistence of SCAD and TTS has been reported in the literature. However, the relationship between these two diseases has not yet been elucidated. PATIENT CONCERNS: A 36-year-old breastfeeding woman was brought to our hospital 52 days after cesarean section because of discomfort in her left arm and convulsions. DIAGNOSES: She was diagnosed of acute myocardial infarction (AMI). The convulsions were attributed to lethal arrhythmia. INTERVENTIONS: An immediate coronary angiography revealed that her left anterior descending artery (LAD) was Type 2a SCAD, but with no flow limitation. In addition, a 12-lead electrocardiogram (ECG) revealed improvement in ST-elevation. We chose the conservative treatment according to the patient's needs. OUTCOMES: Conservative treatment was unsuccessful. She developed another acute myocardial infarction requiring another percutaneous coronary intervention (PCI) during hospitalization. From the course of hospitalization, we suspected the coexistence of SCAD and TTS. LESSONS: When we treat patients with SCAD, we should consider the possibility of coexistence of TTS and confirm left ventricular wall motion. Patients with SCAD may require invasive treatment, hence, should be monitored for a while. An urgent strategy for managing patients with SCAD who require PCI should be established.
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Takeuchi et al. (2021) conducted a case report in Spontaneous coronary artery dissection and possible takotsubo syndrome (n=1). Conservative treatment followed by percutaneous coronary intervention was evaluated. A 36-year-old breastfeeding woman with spontaneous coronary artery dissection and possible takotsubo syndrome initially managed conservatively required percutaneous coronary intervention after a recurrent myocardial infarction.
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