title: Spontaneous Coronary Artery Dissection Misdiagnosed as Takotsubo Cardiomyopathy: A Case Series.
abstract: Spontaneous coronary artery dissection (SCAD) and Takotsubo cardiomyopathy (TTC) can both cause myocardial infarction with subsequent normalization of wall motion abnormality. Angiograms of patients with TTC at Vancouver General Hospital were reviewed for SCAD. Clinical and investigational characteristics were recorded. Nine women with nonatherosclerotic SCAD were misdiagnosed as having TTC. Their average age was 55 years. Five patients had hypertension and 4 had emotional or physical stress. Fibromuscular dysplasia was present in 4 women. Wall motion abnormalities corresponded to dissected artery location and subsequently resolved. SCAD should be included in the differential diagnosis of patients suspected of having TTC and coronary angiograms scrutinized for subtle SCAD.
authors.affiliation: Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Annie Y
authors.initials: AY
authors.lastname: Chou
authors.affiliation: Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Sedlak
authors.affiliation: Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Eve
authors.initials: E
authors.lastname: Aymong
authors.affiliation: Division of Cardiology, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Tej
authors.initials: T
authors.lastname: Sheth
authors.affiliation: Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Starovoytov
authors.affiliation: Division of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Karin H
authors.initials: KH
authors.lastname: Humphries
authors.affiliation: Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: G B John
authors.initials: GB
authors.lastname: Mancini
authors.affiliation: Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: jsaw@mail.ubc.ca.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Saw
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000209:etiology*; D003331:Coronary Vessels / Q000473:pathology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis; D014652:Vascular Diseases / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology