Spontaneous multivessel coronary artery dissection: Repeated presentation in a healthy postmenopausal woman

Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction which is infrequently diagnosed antemortem. Most previously repo rted cases were found in women of whom a significant proportion presented d uring pregnancy or the postpartum period. We describe the first antemortem case of spontaneous coronary artery dissection, unrelated to pregnancy or t he postpartum state, which ultimately resulted in diffuse involvement of bo th the left and right coronary arteries over a period of 4 months. Pathophy siology and case management of this disorder are discussed.