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Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series

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 a...

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Autores principales: Saleemi, Saadat Ali, Teng, Lung En, Dick, Ronald J. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147853/
https://www.ncbi.nlm.nih.gov/pubmed/37115413
http://dx.doi.org/10.1186/s43044-023-00361-6
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author Saleemi, Saadat Ali
Teng, Lung En
Dick, Ronald J. L.
author_facet Saleemi, Saadat Ali
Teng, Lung En
Dick, Ronald J. L.
author_sort Saleemi, Saadat Ali
collection PubMed
description 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.
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spelling pubmed-101478532023-04-30 Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series Saleemi, Saadat Ali Teng, Lung En Dick, Ronald J. L. Egypt Heart J Case Report 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. Springer Berlin Heidelberg 2023-04-28 /pmc/articles/PMC10147853/ /pubmed/37115413 http://dx.doi.org/10.1186/s43044-023-00361-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Saleemi, Saadat Ali
Teng, Lung En
Dick, Ronald J. L.
Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title_full Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title_fullStr Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title_full_unstemmed Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title_short Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series
title_sort combined spontaneous coronary artery dissection (scad) and takotsubo syndrome (tts): a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147853/
https://www.ncbi.nlm.nih.gov/pubmed/37115413
http://dx.doi.org/10.1186/s43044-023-00361-6
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