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Percutaneous Coronary Intervention to Spontaneous Coronary Artery Dissection With Coexistent Takotsubo

Ahmed Elsherif1, Pouya Ebrahimi1, Sophia Khattak1,2

  • 1Department of Cardiology Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust Birmingham UK.

Clinical Case Reports
|April 8, 2026
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can mimic Takotsubo Cardiomyopathy (TC). This case highlights successful percutaneous coronary intervention (PCI) for SCAD, leading to full recovery of left ventricular function.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS).
  • SCAD and Takotsubo Cardiomyopathy (TC) share overlapping clinical features and risk factors.
  • Distinguishing between SCAD and TC is crucial for appropriate management.

Purpose of the Study:

  • To report a case of concurrent SCAD and TC.
  • To describe the successful percutaneous coronary intervention (PCI) for SCAD.
  • To illustrate the diagnostic and therapeutic approach in such complex cases.

Main Methods:

  • Coronary angiography (CA) and left ventriculogram were performed.
  • Intracoronary optical frequency domain imaging (OFDI) diagnosed intramural hematoma consistent with SCAD.
  • Percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) was performed.
  • Transthoracic echocardiography (TTE) and cardiac MRI assessed left ventricular function and SCAD healing.

Main Results:

  • The patient presented with chest pain and elevated troponin, showing features of both SCAD and TC.
  • OFDI confirmed SCAD in the D1 artery, which was treated with PCI.
  • Post-PCI, TTE showed initial hypokinesis but demonstrated full recovery of LV systolic function at 3 months.
  • Repeat CA and OFDI at 6 months showed SCAD healing and hematoma resolution.

Conclusions:

  • SCAD can present with clinical and angiographic features mimicking TC.
  • Intracoronary imaging is vital for accurate SCAD diagnosis.
  • PCI can be a safe and effective treatment for SCAD, leading to favorable long-term outcomes and functional recovery.

Keywords:
acute coronary syndromepercutaneous coronary interventionspontaneous coronary artery dissectiontakotsubo cardiomyopathy

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