{"title":"自发性冠状动脉夹层相关takotsubo综合征:病例报告的系统回顾。","authors":"Aditi Bhanushali, Muskan Kohli, Ananya Prakash, Svaapnika Rao Sarvepalli, Anchal Pandey, Olufemi Odugbemi, Nafisa Reyaz, Bansi Trambadia, Sadhu Aishwarya Reddy, Shaylika Chauhan, Rupak Desai","doi":"10.4330/wjc.v15.i8.406","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Spontaneous coronary artery dissection (SCAD) is underdiagnosed and requires comprehensive angiographic findings. Few SCAD occurrences have a comparable clinical appearance as takotsubo syndrome (TTS) or exist simultaneously, making it challenging for clinicians to treat and manage. Case reports lack consolidated data. We examined SCAD-TTS case reports.</p><p><strong>Aim: </strong>To conduct a systematic review of available case reports on SCAD in order to investigate its potential association with TTS.</p><p><strong>Methods: </strong>SCAD-associated TTS case reports were reviewed after thoroughly screening PubMed, EMBASE, Scopus, and Google Scholar databases till January 2023. Case reports described demographics, comorbidities, imaging, management, and results.</p><p><strong>Results: </strong>Twelve articles about 20 female patients were analyzed. 30% of patients (<i>n</i> = 6, > 60 years) were elderly (mean age 56.2 ± 9.07 years, range 36-70 years). Canada has 9 cases, United States 3, Australia 3, Sweden 2, Japan, Denmark, and France 1. Only 5 reports identified emotional stressors in these cases while 4 reports showed physical triggers for TTS. Nine had hypertension, 2 had hyperlipidemia, and 1 had prediabetes. 5 patients (25%) smoked. 10 (50%) troponin-positive myocardial infarction patients reported chest discomfort. 11 (55%) of 20 instances had TTS/SCAD. 12 (60%) of 20 patients exhibited ST elevation and 3 (15%) had T wave inversion on electrocardiogram. 19/20 patients had elevated troponin. 9 (45%) of 20 people had apical akinesis with TTS ballooning on cardiac imaging. All 20 exhibited echocardiographic wall motion abnormalities. 19 (95%) of 20 coronary angiography cases had SCAD. 10 of 19 SCAD patients had left anterior descending, 2 diagonal, and 2 left circumflex coronary artery involvement. 7 of 20 patients had left ventricular ejection fraction (LVEF) data. LVEF averaged 38.78 ± 7.35%. 5 (25%) of the 20 cases underwent dual antiplatelet therapy. Three (15%) of 20 cases experienced occasional ectopic ventricular complexes, Mobitz ll AV block, and paroxysmal atrial fibrillation. All 20 cases recovered and survived.</p><p><strong>Conclusion: </strong>Given the clinical similarities and challenges in detecting TTS and SCAD, this subset needs more research to raise awareness and reduce morbidity.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/c1/WJC-15-406.PMC10523194.pdf","citationCount":"0","resultStr":"{\"title\":\"Spontaneous coronary artery dissection-associated takotsubo syndrome: A systematic review of case reports.\",\"authors\":\"Aditi Bhanushali, Muskan Kohli, Ananya Prakash, Svaapnika Rao Sarvepalli, Anchal Pandey, Olufemi Odugbemi, Nafisa Reyaz, Bansi Trambadia, Sadhu Aishwarya Reddy, Shaylika Chauhan, Rupak Desai\",\"doi\":\"10.4330/wjc.v15.i8.406\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spontaneous coronary artery dissection (SCAD) is underdiagnosed and requires comprehensive angiographic findings. Few SCAD occurrences have a comparable clinical appearance as takotsubo syndrome (TTS) or exist simultaneously, making it challenging for clinicians to treat and manage. Case reports lack consolidated data. We examined SCAD-TTS case reports.</p><p><strong>Aim: </strong>To conduct a systematic review of available case reports on SCAD in order to investigate its potential association with TTS.</p><p><strong>Methods: </strong>SCAD-associated TTS case reports were reviewed after thoroughly screening PubMed, EMBASE, Scopus, and Google Scholar databases till January 2023. Case reports described demographics, comorbidities, imaging, management, and results.</p><p><strong>Results: </strong>Twelve articles about 20 female patients were analyzed. 30% of patients (<i>n</i> = 6, > 60 years) were elderly (mean age 56.2 ± 9.07 years, range 36-70 years). Canada has 9 cases, United States 3, Australia 3, Sweden 2, Japan, Denmark, and France 1. Only 5 reports identified emotional stressors in these cases while 4 reports showed physical triggers for TTS. Nine had hypertension, 2 had hyperlipidemia, and 1 had prediabetes. 5 patients (25%) smoked. 10 (50%) troponin-positive myocardial infarction patients reported chest discomfort. 11 (55%) of 20 instances had TTS/SCAD. 12 (60%) of 20 patients exhibited ST elevation and 3 (15%) had T wave inversion on electrocardiogram. 19/20 patients had elevated troponin. 9 (45%) of 20 people had apical akinesis with TTS ballooning on cardiac imaging. All 20 exhibited echocardiographic wall motion abnormalities. 19 (95%) of 20 coronary angiography cases had SCAD. 10 of 19 SCAD patients had left anterior descending, 2 diagonal, and 2 left circumflex coronary artery involvement. 7 of 20 patients had left ventricular ejection fraction (LVEF) data. LVEF averaged 38.78 ± 7.35%. 5 (25%) of the 20 cases underwent dual antiplatelet therapy. Three (15%) of 20 cases experienced occasional ectopic ventricular complexes, Mobitz ll AV block, and paroxysmal atrial fibrillation. All 20 cases recovered and survived.</p><p><strong>Conclusion: </strong>Given the clinical similarities and challenges in detecting TTS and SCAD, this subset needs more research to raise awareness and reduce morbidity.</p>\",\"PeriodicalId\":23800,\"journal\":{\"name\":\"World Journal of Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/c1/WJC-15-406.PMC10523194.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4330/wjc.v15.i8.406\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4330/wjc.v15.i8.406","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Spontaneous coronary artery dissection-associated takotsubo syndrome: A systematic review of case reports.
Background: Spontaneous coronary artery dissection (SCAD) is underdiagnosed and requires comprehensive angiographic findings. Few SCAD occurrences have a comparable clinical appearance as takotsubo syndrome (TTS) or exist simultaneously, making it challenging for clinicians to treat and manage. Case reports lack consolidated data. We examined SCAD-TTS case reports.
Aim: To conduct a systematic review of available case reports on SCAD in order to investigate its potential association with TTS.
Methods: SCAD-associated TTS case reports were reviewed after thoroughly screening PubMed, EMBASE, Scopus, and Google Scholar databases till January 2023. Case reports described demographics, comorbidities, imaging, management, and results.
Results: Twelve articles about 20 female patients were analyzed. 30% of patients (n = 6, > 60 years) were elderly (mean age 56.2 ± 9.07 years, range 36-70 years). Canada has 9 cases, United States 3, Australia 3, Sweden 2, Japan, Denmark, and France 1. Only 5 reports identified emotional stressors in these cases while 4 reports showed physical triggers for TTS. Nine had hypertension, 2 had hyperlipidemia, and 1 had prediabetes. 5 patients (25%) smoked. 10 (50%) troponin-positive myocardial infarction patients reported chest discomfort. 11 (55%) of 20 instances had TTS/SCAD. 12 (60%) of 20 patients exhibited ST elevation and 3 (15%) had T wave inversion on electrocardiogram. 19/20 patients had elevated troponin. 9 (45%) of 20 people had apical akinesis with TTS ballooning on cardiac imaging. All 20 exhibited echocardiographic wall motion abnormalities. 19 (95%) of 20 coronary angiography cases had SCAD. 10 of 19 SCAD patients had left anterior descending, 2 diagonal, and 2 left circumflex coronary artery involvement. 7 of 20 patients had left ventricular ejection fraction (LVEF) data. LVEF averaged 38.78 ± 7.35%. 5 (25%) of the 20 cases underwent dual antiplatelet therapy. Three (15%) of 20 cases experienced occasional ectopic ventricular complexes, Mobitz ll AV block, and paroxysmal atrial fibrillation. All 20 cases recovered and survived.
Conclusion: Given the clinical similarities and challenges in detecting TTS and SCAD, this subset needs more research to raise awareness and reduce morbidity.