A case report of recurrent spontaneous coronary artery dissection and Takotsubo cardiomyopathy: a treatment dilemma

European Heart Journal. Case Reports
Hafiz U GhafoorJoseph Hannan

Abstract

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome in younger females with no pre-existing history of coronary artery disease. Recurrent SCAD is common after a first episode and can involve the same coronary artery or present as a new dissection unrelated to the initial lesion. Current recommendations advise for a conservative approach in the absence of haemodynamic compromise and flow limitations. Conversely, there are no clear guidelines for the management of early recurrent SCAD. A 52-year-old woman with history of obesity, asthma, and prediabetes presented with chest pain and electrocardiogram (ECG) showing inferior wall ST-elevation myocardial infarction (STEMI). Coronary angiography revealed proximal right coronary artery (RCA) dissection and distal left anterior descending artery (LAD) dissection, while left ventriculogram showed Takotsubo cardiomyopathy (TC). Angiography revealed no flow limitations so conservative management was pursued. She returned within a couple of days with recurrent chest pain and ECG showing similar findings of inferior STEMI. Repeat angiography confirmed progression of the proximal RCA SCAD with resolution of distal LAD SCAD. Since flow through the dis...Continue Reading

References

May 8, 2010·Heart·Christian J M Vrints
Nov 15, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jacqueline Saw
Nov 20, 2014·Circulation. Cardiovascular Interventions·Marysia S TweetRajiv Gulati
Oct 11, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Antonio RuggieroJacqueline Saw
Aug 26, 2017·Journal of the American College of Cardiology·Jacqueline SawG B John Mancini
Feb 24, 2018·Circulation·Sharonne N HayesUNKNOWN American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular
Mar 6, 2018·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Shams Y-Hassan

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Methods Mentioned

BETA
dissection
contraception
hormone replacement therapy
coronary artery bypass

Related Concepts

Related Feeds

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.