A Bidirectional Relationship Between Spontaneous Coronary Artery Dissection and Stress-Induced Cardiomyopathy in a Perimenopausal Woman: A Case Report.
- 1Internal Medicine, Ball Memorial Hospital, Indiana University School of Medicine, Muncie, USA.
- 2Internal Medicine, Ball Memorial Hospital, Muncie, USA.
- 3Cardiology, Ball Memorial Hospital, Muncie, USA.
Abstract
Spontaneous coronary artery dissection (SCAD) and stress-induced cardiomyopathy (SICM) are non-atherosclerotic causes of acute coronary syndrome that predominantly affect women. Their overlapping clinical, electrocardiographic, biomarker, and imaging features can make diagnosis challenging, and although their coexistence is increasingly recognized, the relationship between these entities remains poorly understood. A 48-year-old female with cardiovascular risk factors presented with back and scapular pain and ST-segment elevations. Coronary angiography revealed Yip-Saw Class 2 SCAD in the mid-distal LAD with preserved flow. Echocardiography demonstrated wall motion abnormalities extending beyond the LAD territory with a reduced ejection fraction and apical ballooning suggesting concurrent SICM. This case illustrates the concept that SCAD and SICM are important non-atherosclerotic causes of acute coronary syndrome in women and may present with overlapping features that complicate diagnosis. Their coexistence is biologically plausible given their marked female predominance and shared susceptibility related to estrogen-mediated vascular protection, which may be diminished during the perimenopausal transition. Clinicians should consider concurrent SICM when evaluating patients with SCAD, particularly when wall motion abnormalities extend beyond the affected coronary distribution.
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BibTeX
@article{panyala2026bidirectional,
title = {{A Bidirectional Relationship Between Spontaneous Coronary Artery Dissection and Stress-Induced Cardiomyopathy in a Perimenopausal Woman: A Case Report.}},
author = {Nitya Panyala and Mohammad Freihat and Amanjit Singh and Manuel Rivera},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116673},
url = {https://europepmc.org/article/MED/42923796},
note = {CC BY},
}
RIS
TY - JOUR
TI - A Bidirectional Relationship Between Spontaneous Coronary Artery Dissection and Stress-Induced Cardiomyopathy in a Perimenopausal Woman: A Case Report.
AU - Nitya Panyala
AU - Mohammad Freihat
AU - Amanjit Singh
AU - Manuel Rivera
PY - 2026
DA - 2026/09/21
JO - Cureus
DO - 10.7759/cureus.116673
UR - https://europepmc.org/article/MED/42923796
AB - Spontaneous coronary artery dissection (SCAD) and stress-induced cardiomyopathy (SICM) are non-atherosclerotic causes of acute coronary syndrome that predominantly affect women. Their overlapping clinical, electrocardiographic, biomarker, and imaging features can make diagnosis challenging, and although their coexistence is increasingly recognized, the relationship between these entities remains poorly understood. A 48-year-old female with cardiovascular risk factors presented with back and scapular pain and ST-segment elevations. Coronary angiography revealed Yip-Saw Class 2 SCAD in the mid-distal LAD with preserved flow. Echocardiography demonstrated wall motion abnormalities extending beyond the LAD territory with a reduced ejection fraction and apical ballooning suggesting concurrent SICM. This case illustrates the concept that SCAD and SICM are important non-atherosclerotic causes of acute coronary syndrome in women and may present with overlapping features that complicate diagnosis. Their coexistence is biologically plausible given their marked female predominance and shared susceptibility related to estrogen-mediated vascular protection, which may be diminished during the perimenopausal transition. Clinicians should consider concurrent SICM when evaluating patients with SCAD, particularly when wall motion abnormalities extend beyond the affected coronary distribution.
SN - 2168-8184
ER -