title: Spontaneous coronary artery dissection and takotsubo syndrome: The chicken or the egg causality dilemma.
abstract: Acute coronary syndrome (ACS) including spontaneous coronary artery dissection (SCAD) has been reported to trigger its own clinical twin takotsubo syndrome (TS). The pathogenetic association between SCAD and TS remains to be elucidated. The two diseases afflict predominantly women and both conditions may be triggered by an emotional stress factor and an unusual extreme physical exercise. Herein, we describe a case of 54-year-old woman presenting with ACS caused by an obtuso-marginal SCAD. Concurrently, the patient had typical clinical features and course of mid-apical pattern of TS. The causal link between the two conditions is discussed. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Shams
authors.initials: S
authors.lastname: Y-Hassan
authors.affiliation: Department of Radiology, Karolinska institutet, and Karolinska Unversity Hospital, Stockholm, Sweden.
authors.forename: Raquel
authors.initials: R
authors.lastname: Themudo
authors.affiliation: Department of Clinical Physiology, Karolinska institutet, and Karolinska Unversity Hospital, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Maret
mesh_terms: D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy
keywords: SCAD; apical ballooning; myocardial infarction; myocardial stunning; spontaneous coronary artery dissection; takotsubo