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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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  • Contributors I certify that neither this manuscript nor one with substantially similar content under my authorship has been published or is being considered for publication elsewhere. I have access to any data upon which the manuscript is based and will provide such data upon request to the editors or their assignees. I have given final approval of the submitted manuscript for which I take public responsibility for whole content. According to the definition given by the International Committee of Medical Journal Editors (ICMJE), all named authors qualify for authorship based on making substantial contributions to the intellectual content. I, AP, am the corresponding author and I prepared the initial draft of the manuscript. VL reviewed and amended the initial draft. RK was the consultant of the patient; he identified the case, provided the images, reviewed and amended the final version of the manuscript.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.