Spontaneous coronary artery dissection is a rare disease that occurs m
ost commonly in young people, especially in peripartum or postpartum w
omen. It has rarely been diagnosed during life and has never before be
en observed associated with any other non-ischaemic heart disease. We
report a case associated with mitral stenosis, in which successful val
vular and coronary surgery were carried out. We speculate whether rheu
matic coronary arteritis was a cause of the dissection.