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The follow electronic only articles are published in conjunction with this issue of Heart.

Stress, myocardial infarction, and the “tako-tsubo” phenomenon

K A Connelly, A M MacIsaac, V M Jelinek

Emotional distress as a trigger for acute myocardial infarction is beginning to gain credibility as it is recognised that traditional risk factors can account for only half of all myocardial infarctions. Here, three cases of myocardial infarction are presented in the setting of an acute emotional stressor, with coronary angiography showing only minimal coronary artery disease. In all cases striking wall motion abnormalities, mimicking a “tako-tsubo”, were noted with complete resolution within 30 days. This pattern suggests tako-tsubo-like transient left ventricular dysfunction.

(Heart 2004;90:e52)

Spontaneous coronary artery dissection in the postpartum period: association with antiphospholipid antibody

M Krishnamurthy, R Desai, H Patel

Spontaneous coronary artery dissection (SCAD) is an extremely uncommon cause of myocardial infarction, occurring predominantly in women during or after pregnancy. The exact aetiology is unknown. This report describes a 33 year postpartum woman with diagnosed SCAD who tested positive for anticardiolipin antibody. This is the first case of SCAD in a patient with antiphospholipid antibody. The authors hypothesised that there should be a strong association between them.

(Heart 2004;90:e53)

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