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Coexistence of Spontaneous Coronary Artery Dissection, Takotsubo Cardiomyopathy, and Myocardial Bridge

Shuichi Kegai1, Katsumasa Sato1, Kenji Goto1

  • 1Department of Cardiology, Fukuyama Cardiovascular Hospital, Fukuyama, Japan.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

This case study details spontaneous coronary artery dissection near a myocardial bridge, occurring with takotsubo cardiomyopathy. Advanced imaging techniques were crucial for diagnosing these complex cardiac conditions.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare but serious condition.
  • Myocardial bridges can cause coronary artery compression.
  • Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, mimics heart attack symptoms.

Observation:

  • A patient presented with symptoms suggestive of cardiac events.
  • Diagnostic imaging revealed SCAD adjacent to a myocardial bridge.
  • The patient also exhibited signs of takotsubo cardiomyopathy.

Findings:

  • Multidetector-row computed tomography (MDCT) and single-photon emission computed tomography (SPECT) fusion imaging provided detailed visualization.
  • This advanced imaging approach successfully identified the co-occurrence of SCAD and myocardial bridging.
  • The diagnostic utility of fused MDCT-SPECT imaging in complex coronary artery pathologies was demonstrated.

Implications:

  • This case highlights the importance of considering multiple pathologies in patients with overlapping cardiac symptoms.
  • Fusion imaging offers a valuable tool for diagnosing intricate coronary artery abnormalities.
  • Understanding these combined conditions can improve patient management and outcomes.

Keywords:
123I-BMIPP, iodine-123 beta-methyl iodophenyl pentadecanoic acidCAG, coronary angiographyECG, electrocardiogramIVUS, intravascular ultrasonographyLAD, left anterior descending arteryMB, myocardial bridgeMDCT, multidetector-row computed tomographySCAD, spontaneous coronary artery dissectionSPECT, single-photon emission computed tomographyTC, takotsubo cardiomyopathyapical ballooningmyocardial bridgespontaneous coronary artery dissectiontakotsubo cardiomyopathy

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