This case report describes the devastating consequences of spontaneous coro
nary dissection in a 36-year-old female patient. Surgical revascularization
was attempted, but diffuse myocardial infarction developed. The patient wa
s bridged to heart trans plantation but died secondary to multiple organ fa
ilure. To our knowledge, this is the only reported case of spontaneous diss
ection of the three main coronary arteries due to severe cystic medial necr
osis.