Key result
A 67-year-old woman presenting with ST-elevation myocardial infarction treated with fibrinolysis was found to have obtuse-marginal spontaneous coronary artery dissection and takotsubo syndrome.
Why the study?
SCAD is an under-recognized acute cardiac disease entity that is often missed or misdiagnosed as coronary spasm, atherosclerotic lesion, thrombotic coronary occlusion, or takotsubo syndrome.
Case Report (n=1)
This case highlights the diagnostic challenges of SCAD, which can mimic STEMI and coexist with takotsubo syndrome, potentially leading to inappropriate fibrinolytic therapy.
Caution against empiric fibrinolysis in ambiguous STEMI; case reports leave optimal differentiation of SCAD-takotsubo overlap open.
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an under-recognized acute cardiac disease entity. It is often missed, or misdiagnosed as coronary spasm, coronary atherosclerotic lesion, or thrombotic coronary occlusion. During the last years, SCAD also has been reported to be 'misdiagnosed as takotsubo syndrome (TS)' in patients with features consistent with both conditions. Spontaneous coronary artery dissection may present as an acute coronary syndrome and sometimes as sudden cardiac death. CASE SUMMARY: We report on the case of a 67-year-old woman who presented with features of ST-elevation myocardial infarction treated with fibrinolysis. The patient showed to have obtuse-marginal SCAD, which was misdiagnosed as fibrinolysis caused lysis of a coronary thrombus. The patient had moreover all other features of TS. DISCUSSION: This case report teaches important information about SCAD. The association between SCAD and TS are discussed.
No takes yet. Share an insight, caveat, or question.
Y‐Hassan et al. (2018) conducted a case report in Spontaneous coronary artery dissection associated with takotsubo syndrome (n=1). Fibrinolysis was evaluated. A 67-year-old woman presenting with ST-elevation myocardial infarction treated with fibrinolysis was found to have obtuse-marginal spontaneous coronary artery dissection and takotsubo syndrome.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: