Apr 26, 2019

Fibrinolysis-treated myocardial infarction in a patient with missed spontaneous coronary artery dissection associated with takotsubo syndrome: case report

European Heart Journal. Case Reports
Shams Y-Hassan, Loghman Henareh


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. 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. This case report teaches important information about SCAD. The association between SCAD and TS are discussed.

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Mentioned in this Paper

Deficiency of butyryl-CoA Dehydrogenase
Coronary Occlusion
Myocardial Infarction
Acute Disease
Takotsubo Cardiomyopathy
Coronary Artery Vasospasm
Procedures on Coronary Arteries
Sudden Cardiac Death

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