{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:10:12Z","timestamp":1756368612642,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,9,14]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>New-onset Takotsubo cardiomyopathy following spontaneous coronary artery dissection (SCAD) is rare. We report a middle-aged woman without significant cardiovascular risk factors, who initially presented with non-ST-elevation myocardial infarction (NSTEMI) with angiography showing sudden \u2018pruning\u2019 of the coronary artery consistent with SCAD. One week later, the patient returned with recurrent NSTEMI. Repeat coronary angiogram showed no change in SCAD, but ventriculogram revealed new-onset apical ballooning beyond the SCAD-affected territory, consistent with Takotsubo cardiomyopathy. Further head-to-pelvis angiogram revealed an irregular beaded appearance of the left vertebral artery consistent with fibromuscular dysplasia. The patient was managed conservatively with aspirin, carvedilol and escitalopram with complete resolution of cardiac and mood symptoms. Our case supports an association between SCAD and Takotsubo cardiomyopathy in a potentially mutually aggravating process. Clinical vigilance is therefore required to rule out the other condition when one of the two entities is diagnosed.<\/jats:p>","DOI":"10.1136\/bcr-2024-261602","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T10:45:34Z","timestamp":1727779534000},"page":"e261602","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Development of Takotsubo cardiomyopathy following spontaneous coronary artery dissection in a patient with fibromuscular dysplasia"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2751-7985","authenticated-orcid":false,"given":"Qiuyu Martin","family":"Zhu","sequence":"first","affiliation":[{"name":"Internal Medicine Residency, Kaiser Permanente Mid-Atlantic States, Gaithersburg, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie M","family":"Chen","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency, Kaiser Permanente Mid-Atlantic States, Gaithersburg, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"2025082800523819000_17.10.e261602.1","first-page":"485","article-title":"Spontaneous coronary artery dissection and its association with takotsubo syndrome: Novel insights from a tertiary center registry","volume":"95","author":"Duran","year":"2020","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025082800523819000_17.10.e261602.2","first-page":"1410","article-title":"On a Plausible Association of Spontaneous Coronary Artery Dissection and Takotsubo Syndrome","volume":"31","author":"Madias","year":"2015","journal-title":"Can J Cardiol"},{"key":"2025082800523819000_17.10.e261602.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000564"},{"key":"2025082800523819000_17.10.e261602.4","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.carrev.2018.02.002","article-title":"Spontaneous coronary artery dissection and takotsubo syndrome: An often overlooked association; review","volume":"19","author":"Y-Hassan","year":"2018","journal-title":"Cardiovasc Revasc Med"},{"key":"2025082800523819000_17.10.e261602.5","doi-asserted-by":"crossref","first-page":"5489","DOI":"10.21037\/jtd.2017.11.07","article-title":"The link between spontaneous coronary artery dissection and takotsubo cardiomyopathy: analysis of the published cases","volume":"9","author":"Buccheri","year":"2017","journal-title":"J Thorac Dis"},{"key":"2025082800523819000_17.10.e261602.6","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1016\/j.jcin.2021.06.027","article-title":"Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases","volume":"14","author":"Adlam","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2025082800523819000_17.10.e261602.7","first-page":"1073","article-title":"Spontaneous Coronary Artery Dissection Misdiagnosed as Takotsubo Cardiomyopathy: A Case Series","volume":"31","author":"Chou","year":"2015","journal-title":"Can J Cardiol"},{"key":"2025082800523819000_17.10.e261602.8","doi-asserted-by":"crossref","unstructured":"Macaya F , Vedia O , Gonzalo N , et al . 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