Open AccessA breastfeeding woman with spontaneous coronary artery dissection and possible takotsubo syndrome
Author(s) -
Makoto Takeuchi,
Takenori Okada,
Yuki Ikegami,
Yumiko Nakamoto,
Naomi Idei,
Norihiko Ohashi
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000025775
Subject(s) - medicine , scad , takotsubo syndrome , myocardial infarction , cardiology , percutaneous coronary intervention , acute coronary syndrome , conventional pci , heart failure , cardiomyopathy
Rationale: The relationship between spontaneous coronary artery dissection (SCAD) and takotsubo syndrome (TTS) remains unclear. Coexistence of SCAD and TTS has been reported in the literature. However, the relationship between these two diseases has not yet been elucidated. Patient concerns: A 36-year-old breastfeeding woman was brought to our hospital 52 days after cesarean section because of discomfort in her left arm and convulsions. Diagnoses: She was diagnosed of acute myocardial infarction (AMI). The convulsions were attributed to lethal arrhythmia. Interventions: An immediate coronary angiography revealed that her left anterior descending artery (LAD) was Type 2a SCAD, but with no flow limitation. In addition, a 12-lead electrocardiogram (ECG) revealed improvement in ST-elevation. We chose the conservative treatment according to the patient's needs. Outcomes: Conservative treatment was unsuccessful. She developed another acute myocardial infarction requiring another percutaneous coronary intervention (PCI) during hospitalization. From the course of hospitalization, we suspected the coexistence of SCAD and TTS. Lessons: When we treat patients with SCAD, we should consider the possibility of coexistence of TTS and confirm left ventricular wall motion. Patients with SCAD may require invasive treatment, hence, should be monitored for a while. An urgent strategy for managing patients with SCAD who require PCI should be established.