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A man in his late 50s with a medical history of multiple sclerosis presented with sudden-onset sharp central chest pain, which radiated to the back, jaw and neck. CT aorta ruled out aortic dissection. Blood results showed dynamic troponin-T rise and his ECG showed T-wave inversion in inferolateral leads. He had a coronary angiography. It showed smooth unobstructed right coronary artery and left coronary system was smooth walled except for short stenotic segment in the circumflex artery (moderate-severe) (figure 1A). Spontaneous coronary artery dissection was suspected. He was treated with optimum medical therapy and discharged home.
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Contributors All the authors contributed equally.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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