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April 8, 2026Clinical Case Reports1 citationsOpen Access

Percutaneous Coronary Intervention to Spontaneous Coronary Artery Dissection With Coexistent Takotsubo Cardiomyopathy: A Case Report

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AEAhmed ElsherifPEPouya EbrahimiSKSophia Khattak

Key Result

Percutaneous coronary intervention with a drug-eluting stent successfully treated a 55-year-old female with spontaneous coronary artery dissection and coexistent Takotsubo cardiomyopathy.

Key Points

  • To explore the treatment approach and outcomes of a patient with SCAD and concurrent TC.
  • Case report of a 55-year-old female patient
  • Percutaneous coronary intervention performed due to ongoing symptoms
  • Intracoronary optical frequency domain imaging assessed SCAD severity
  • Transthoracic echocardiography evaluated left ventricular function
  • Initial angiography indicated SCAD in the D1 artery
  • Successful PCI with a drug-eluting stent improved symptoms
  • Echocardiography after 3 months showed normal left ventricular function
  • Healing of SCAD and intramural hematoma resolution observed at follow-up

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
1 55-year-old female presenting with chest pain, elevated troponin, spontaneous coronary artery dissection (SCAD) in the first diagonal (D1) artery, and coexistent Takotsubo Cardiomyopathy (TC).
I
Intervention
Percutaneous coronary intervention (PCI) to the first diagonal (D1) artery using a 2.25 × 12 mm drug-eluting stent (DES), guided by intracoronary optical frequency domain imaging (OFDI).
O
Outcome
Recovery of left ventricular systolic function, resolution of wall motion abnormalities, healing of SCAD, and resolution of intramural hematoma assessed via imaging (TTE, CA, OFDI, MRI).surrogate

PCI with a drug-eluting stent successfully treated a rare case of spontaneous coronary artery dissection coexisting with Takotsubo cardiomyopathy, leading to full structural and functional recovery at 6 months.

Abstract

ABSTRACT Spontaneous coronary artery dissection (SCAD) is an uncommon cause of non‐atherosclerotic acute coronary syndrome (ACS) resulting in myocardial ischemia and ventricular wall motion abnormalities (WMA). SCAD and Takotsubo Cardiomyopathy (TC) share a common risk factor profile and clinical characteristics. We report a 55‐year‐old female patient who presented with chest pain and elevated troponin level. Coronary angiography (CA) showed tortuosity in the first diagonal (D1) artery suspicious of SCAD. Left ventriculogram showed typical apical ballooning of TC. Because of ongoing chest pain during the procedure, we proceeded to percutaneous coronary intervention (PCI) to D1. Intracoronary optical frequency domain imaging (OFDI) of D1 showed intramural hematoma extending to proximal LAD and treated with a 2.25 × 12 mm Promus Element drug‐eluting stent (DES). Transthoracic Echocardiography (TTE) showed mid anterolateral, inferolateral, and all apical hypokinesia of LV with preserved basal segments and mildly impaired systolic function. TTE after 3 months showed fully recovered LV systolic function with resolution of WMA. Repeat CA 6 months later demonstrated healing of SCAD and OFDI showed resolution of the intramural hematoma, and cardiac MRI showed normal LV systolic and full‐thickness delayed enhancement in only the lateral wall.

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Cite This Study

Elsherif et al. (2026) conducted a case report in Spontaneous Coronary Artery Dissection and Takotsubo Cardiomyopathy (n=1). Percutaneous coronary intervention (PCI) with drug-eluting stent (DES) was evaluated. Percutaneous coronary intervention with a drug-eluting stent successfully treated a 55-year-old female with spontaneous coronary artery dissection and coexistent Takotsubo cardiomyopathy.

synapsesocial.com/papers/69d5f17974eaea4b11a7afcchttps://doi.org/10.1002/ccr3.72462
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