We report the case of a middle-aged female who presented with an acute
inferior myocardial infarction treated with intravenous thrombolytics
. Immediate coronary angiography demonstrated the presence of a spiral
dissection and a large thrombus. After 1 week of anticoagulation the
thrombus had resolved, but a large spiral dissection persisted. This w
as confirmed by intracoronary ultrasound. We then review the literatur
e on spontaneous coronary arterial dissection.