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Two-vessel spontaneous coronary artery dissection as a rare cause of acute coronary syndrome
  1. Agata Plonczak,
  2. Vishal Luther,
  3. Raffi Kaprielian
  1. Department of Cardiology, West Middlesex University Hospital, London, UK
  1. Correspondence to Dr Agata Plonczak, West Middlesex University Hospital, Twickenham road, London TW7 6AF, UK; agata.plonczak{at}

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A 50-year-old hypertensive female presented to us with her first episode of anginal sounding chest discomfort at rest. Her 12-lead ECG demonstrated sinus rhythm with evolving antero-lateral T-wave inversion. Twelve-h Troponin-I was raised at 11.14 ng/ml (normal range 0–0.08 ng/ml).

Coronary angiography revealed two-vessel spontaneous coronary artery dissection (SCAD) involving the right coronary artery extending into the postero-lateral artery (figure 1), and the proximal segment of the first diagonal of the left anterior descending artery (figure 2).

Figure 1

Reveals a dissection within the …

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