Emotion-triggered spontaneous coronary artery dissection in a patient with multiple cardiovascular risk factors: navigating the diagnostic overlap with atherosclerotic acute coronary syndrome and Takotsubo cardiomyopathy
Year: 2026
Type: other
Abstract: Spontaneous coronary artery dissection (SCAD), once considered rare, is increasingly recognized as a cause of acute coronary syndrome (ACS) owing to advances in coronary imaging. Although classically described in women with no or minimal cardiovascular risk factors, differentiation from atherosclerotic myocardial infarction remains challenging when multiple risk factors are present. Accurate diagnosis by coronary angiography is essential, because interventions such as percutaneous coronary intervention and thrombolysis may cause harm in SCAD. Diagnostic overlap with Takotsubo cardiomyopathy (TTC; also called stress cardiomyopathy) further complicates early evaluation. Important gaps remain regarding who is at risk, the triggers involved, and the association with fibromuscular dysplasia (FMD). We report a 51-year-old woman with multiple cardiovascular risk factors who developed SCAD two days after an acute emotional stressor, with negative FMD screening. We present the case of a 51-year-old woman who came to the Emergency Department with chest pain after her home was flooded. Initial tests suggested a possible heart attack, given her several risk factors for heart disease. To confirm the diagnosis, a procedure called coronary angiography was performed, which showed a tear in the wall of one of the arteries supplying the heart. She was treated with medication and recovered fully, with no complications at her follow-up visits.
Source: Figshare
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204450334