{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T14:13:37Z","timestamp":1751552017129,"version":"3.37.3"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T00:00:00Z","timestamp":1598572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In patients suspected of acute coronary syndrome, but where the coronary angiography (CAG) has shown unobstructed coronary arteries differential diagnoses include spontaneous coronary artery dissection and takotsubo cardiomyopathy. This case report presents a patient with spontaneous coronary artery dissection but diagnostic signs suspicious of takotsubo cardiomyopathy. Which leads to a consideration of the co-existence of the diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 57-year-old woman was acutely admitted to the emergency ward with sudden development of chest discomfort, palpitations, and dyspnoea. At hospitalization, the electrocardiography showed T-wave inversions in I, aVL, and V2, and Troponin I was elevated. Initial echocardiography revealed apical akinesia consistent with takotsubo cardiomyopathy. Initially, a diagnosis of acute coronary syndrome or takotsubo cardiomyopathy was suspected. The patient was further diagnostically assessed with CAG including optical coherence tomography which showed spontaneous coronary artery dissection in the left anterior descending artery. At follow-up 3 months later, CAG showed a fully healed coronary artery, and repeated echocardiography showed normalization of the left ventricular function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>In this case report, initially, acute coronary syndrome was suspected due to electrocardiography with T-wave inversions and elevated cardiac biomarkers. Takotsubo cardiomyopathy was suspected when echocardiography showed apical ballooning, but CAG with optical coherence tomography revealed a spontaneous coronary artery dissection. Interestingly no severe obstructions of coronary arteries were seen, and follow-up echocardiography showed fully regained myocardial function. This leads to the debate as to whether this might be a case of co-existing spontaneous coronary artery dissection and takotsubo cardiomyopathy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa172","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T16:44:03Z","timestamp":1598892243000},"page":"1-6","source":"Crossref","is-referenced-by-count":2,"title":["Case report: spontaneous coronary artery dissection and suspicion of takotsubo cardiomyopathy in a patient presenting with T-wave inversions, severe QTc prolongation, elevated cardiac biomarkers, and apical akinesia"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4192-319X","authenticated-orcid":false,"given":"K\u00e5re Peter","family":"Frederiksen","sequence":"first","affiliation":[{"name":"Roskilde Department of Cardiology, Zealand University Hospital, Denmark"},{"name":"Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet - Copenhagen University Hospital, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helle","family":"S\u00f8holm","sequence":"additional","affiliation":[{"name":"Roskilde Department of Cardiology, Zealand University Hospital, Denmark"},{"name":"Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-1861","authenticated-orcid":false,"given":"Ole","family":"Havndrup","sequence":"additional","affiliation":[{"name":"Roskilde Department of Cardiology, Zealand University Hospital, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Procida","sequence":"additional","affiliation":[{"name":"Roskilde Department of Cardiology, Zealand University Hospital, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,28]]},"reference":[{"key":"2020110901530779100_ytaa172-B1","doi-asserted-by":"crossref","first-page":"3353","DOI":"10.1093\/eurheartj\/ehy080","article-title":"European Society of Cardiology, acute cardiovascular care association, SCAD study group: a position paper on spontaneous coronary artery dissection","volume":"39","author":"Adlam","year":"2018","journal-title":"Eur Heart J"},{"key":"2020110901530779100_ytaa172-B2","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1002\/ccd.22115","article-title":"Spontaneous coronary artery dissection: a Western Denmark Heart Registry study","volume":"74","author":"Mortensen","year":"2009","journal-title":"Cathet Cardiovasc Intervent"},{"key":"2020110901530779100_ytaa172-B3","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.cjca.2014.01.011","article-title":"Nonatherosclerotic coronary artery disease in young women","volume":"30","author":"Saw","year":"2014","journal-title":"Can J Cardiol"},{"key":"2020110901530779100_ytaa172-B4","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.ijcard.2016.01.188","article-title":"Prognostic impact of spontaneous coronary artery dissection in young female patients with acute myocardial infarction: a report from the Angina Pectoris-Myocardial Infarction Multicenter Investigators in Japan","volume":"207","author":"Nakashima","year":"2016","journal-title":"Int J Cardiol"},{"first-page":"e2236","year":"2017","author":"Motre","key":"2020110901530779100_ytaa172-B5"},{"key":"2020110901530779100_ytaa172-B6","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/eurheartj\/ehy077","article-title":"International Expert Consensus Document on Takotsubo Syndrome (Part II): diagnostic workup, outcome, and management","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2020110901530779100_ytaa172-B7","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International Expert Consensus Document on Takotsubo Syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2020110901530779100_ytaa172-B8","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.ijcard.2015.11.047","article-title":"The causal link between spontaneous coronary artery dissection and takotsubo syndrome: a case presented with both conditions","volume":"203","author":"Y-Hassan","year":"2016","journal-title":"Int J Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/5\/1\/34168186\/ytaa172.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/5\/1\/34168186\/ytaa172.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T06:53:24Z","timestamp":1604904804000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/5\/1\/5898469"}},"subtitle":[],"editor":[{"given":"Ruben Casado","family":"Arroyo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"John","family":"Kanakakis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luca","family":"Arcari","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Domenico","family":"D'Amario","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Rahoul","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,28]]},"references-count":8,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,8,28]]},"published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa172","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,8,28]]}}}