{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:40:56Z","timestamp":1790858456326,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Takotsubo syndrome (TTS) mimics acute myocardial infarction in the absence of culprit coronary artery disease and is more common in women. Spontaneous coronary artery dissection (SCAD) shares a predilection for women, can result in left ventricular wall motion abnormalities similar to TTS, and may manifest subtle angiographic findings. The aim of this study was to determine the frequency of SCAD misdiagnosed as TTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Coronary angiograms of patients presenting with a provisional diagnosis of TTS were retrospectively reviewed by an independent expert blinded to left ventriculography and the specific purpose of the study to assess for SCAD. TTS was defined using European Society for Cardiology criteria. SCAD was categorized according to the Saw angiographic classification. Among 80 women with a provisional diagnosis of TTS, 2 (2.5%) met angiographic criteria for definite SCAD. Both dissections were located in the distal left anterior descending coronary artery and classified as type 2b. The wall motion abnormality was apical in both cases. An additional 7 patients (9%) had angiography that was indeterminate for SCAD. Clinical characteristics of patients with and without SCAD were similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with a provisional diagnosis of TTS, definite SCAD in the left anterior descending coronary artery\u00a0was present in 2.5% of cases, and coronary angiography was indeterminate for SCAD in an additional 9%. Careful review of\u00a0coronary angiography may avoid missed diagnoses of SCAD in patients with myocardial infarction, nonobstructive coronary\u00a0arteries, and wall motion abnormalities consistent with TTS. Intracoronary imaging maybe considered to establish a definitive diagnosis of SCAD when angiography is inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.013581","type":"journal-article","created":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T05:00:23Z","timestamp":1573534823000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Spontaneous Coronary Artery Dissection in Patients With a Provisional Diagnosis of Takotsubo Syndrome"],"prefix":"10.1161","volume":"8","author":[{"given":"Ana\u00efs","family":"Hausvater","sequence":"first","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel R.","family":"Smilowitz","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Saw","sequence":"additional","affiliation":[{"name":"Division of Cardiology Vancouver General Hospital Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sherrid","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thara","family":"Ali","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalisa","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rediet","family":"Mersha","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"DeFonte","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmony R.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Soter Center for Women's Cardiovascular Research Leon H. Charney Division of Cardiology Department of Medicine New York University School of Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy076"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcy045"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406761"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.034"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000564"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.08.017"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001760"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz007"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.01.188"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.01.011"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.105718"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.004"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2015.03.018"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.11.047"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2012.11.005"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2018.02.002"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25293"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.08.016"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26022"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy080"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.07.043"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2018.08.004"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.013581","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:24:40Z","timestamp":1715585080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.013581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,19]]},"references-count":22,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2019,11,19]]}},"alternative-id":["10.1161\/JAHA.119.013581"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.013581","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,19]]},"assertion":[{"value":"2019-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013581"}}