Related Experiment Video
Updated: Aug 1, 2025
Operating Transverse Aortic Constriction with Absorbable Suture to Obtain Transient Myocardial Hypertrophy
Published on: September 9, 2020
Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
Saadat Ali Saleemi1,2,3, Lung En Teng4, Ronald J L Dick5
1Department of Cardiology, Epworth Richmond, Victoria, 3121, Australia. saadatali.saleemi@gmail.com.
Insights
Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) can occur together in patients presenting with chest pain. Recognizing this combination is crucial for effective patient management and treatment strategies.
Area of Science:
- Cardiology
- Cardiovascular Medicine
Background:
- Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) are distinct cardiac conditions.
- Both SCAD and TTS share common risk factors.
- Concurrent SCAD and TTS presentation complicates patient management.
Purpose of the Study:
- To present two cases of co-existing SCAD and TTS.
- To highlight the importance of identifying SCAD in TTS patients.
Main Methods:
- Case 1: An 80-year-old female with chest pain, ECG changes, SCAD (distal LAD), and TTS (apical ballooning).
- Case 2: A 60-year-old female with chest pain, SCAD (mid-LAD), and TTS (apical ballooning, LV apex akinesis).
- Both patients managed with antiplatelets, ARB/ACE inhibitor, and one with warfarin.
Main Results:
- Both cases demonstrated SCAD and TTS concurrently.
- Case 1 treated with aspirin and ARB.
- Case 2 treated with aspirin, ACE inhibitor, and warfarin.
Conclusions:
- SCAD and TTS can co-exist in patients presenting with chest pain.
- Identifying SCAD in TTS patients is vital for optimal short- and long-term management.
Background:
Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) are two different entities with several shared risk factors, but their management is different. They can co-exist in patients with chest pain which affects their management. We present two cases of combined SCAD and TTS in patients presented with chest pain.
Case Presentation:
Case 1: 80F admitted with typical chest pain and dynamic ECG changes on the background of known anxiety/depression and social stresses. Her coronary angiogram showed SCAD affecting distal LAD. The left ventriculogram (LV gram) showed apical ballooning consistent with Takotsubo Syndrome (TTS). Patient was discharged on aspirin as well as angiotensin receptor blocker (ARB). Case 2: 60F admitted with typical chest pain in the setting of emotional trauma on the background of known cardiovascular risk factors. She was found to have ST elevation in inferior leads with no reciprocal changes. Subsequently, coronary angiogram showed SCAD affecting mid-left anterior descending artery (LAD) with normal distal wrap around LAD. Her LV gram showed apical ballooning consistent with TTS. However, transthoracic echocardiogram showed akinetic left ventricular apex. She was discharged on aspirin as well as an ACE inhibitor and warfarin to prevent LV thrombus.
Conclusions:
SCAD and TTS can co-exist in patients with chest pain. It is important to identify SCAD in patients with TTS as it may affect their short as well as long-term management.
More Related Videos
06:39Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease II: Pathophysiology