A Bidirectional Relationship Between Spontaneous Coronary Artery Dissection and Stress-Induced Cardiomyopathy in a Perimenopausal Woman: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: Spontaneous coronary artery dissection (SCAD) and stress-induced cardiomyopathy (SICM) are non-atherosclerotic causes of acute coronary syndrome that predominantly affect women. Their overlapping clinical, electrocardiographic, biomarker, and imaging features can make diagnosis challenging, and although their coexistence is increasingly recognized, the relationship between these entities remains poorly understood. A 48-year-old female with cardiovascular risk factors presented with back and scapular pain and ST-segment elevations. Coronary angiography revealed Yip-Saw Class 2 SCAD in the mid-distal LAD with preserved flow. Echocardiography demonstrated wall motion abnormalities extending beyond the LAD territory with a reduced ejection fraction and apical ballooning suggesting concurrent SICM. This case illustrates the concept that SCAD and SICM are important non-atherosclerotic causes of acute coronary syndrome in women and may present with overlapping features that complicate diagnosis. Their coexistence is biologically plausible given their marked female predominance and shared susceptibility related to estrogen-mediated vascular protection, which may be diminished during the perimenopausal transition. Clinicians should consider concurrent SICM when evaluating patients with SCAD, particularly when wall motion abnormalities extend beyond the affected coronary distribution.
Source: Cureus
Institutions: Ball Memorial Hospital, Indiana University School of Medicine
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213935830