Abstract

A 72-year-old lady without any conventional cardiovascular risk factors presented to the emergency room with severe anginal chest pain. ECG showed lateral wall ST-elevation and serial serum troponins were elevated. Emergent cardiac catheterization showed spontaneous coronary artery dissection involving the first diagonal artery with angiographically normal other epicardial coronary arteries. Left ventriculogram and echocardiogram showed a moderately reduced left ventricular systolic function with akinetic mid to distal myocardial segments and normal basal contraction suggestive of stress-induced cardiomyopathy. Spontaneous coronary artery dissection presenting with ST-elevation myocardial infarction and stress-induced cardiomyopathy is very rare.