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case_images: Case 1. Right anterior oblique (RAO) cranial image of left coronary angiography showing spontaneous coronary artery dissection of left main (LM) and left anterior descending (LAD) artery (arrows).
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case_images: SCAD of the left main (LM), left anterior descending (LAD), and left circumflex arteries (LCx; Figure 1). She was managed with emergent coronary artery bypass graft (CABG) of 2 vessels, including, left internal mammary artery to the LAD and saphenous vein graft (SVG) to the ramus intermedius artery.
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case_images: Case 2. Right anterior oblique (RAO) cranial view of right coronary angiography showing spontaneous coronary artery dissection of right coronary artery (RCA) (arrows).
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case_images: He was taken to the cardiac catheterization laboratory where coronary angiography showed dissection of both the LAD and the right coronary artery (RCA; Figure 2).
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case_images: Case 3. Right anterior oblique (RAO) cranial view of right coronary angiography showing spontaneous coronary artery dissection of proximal to mid right coronary artery (RCA) (arrows).
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case_images: Repeat catheterization showed stable LAD dissection with new RCA dissection with TIMI grade 1 flow (incomplete filling of distal coronary artery; Figure 3).
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case_images: Case 5. Right anterior oblique (RAO) cranial view of left coronary angiography showing spontaneous coronary artery dissection of mid-left anterior descending (LAD) artery (arrows).
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case_images: Emergent catheterization revealed SCAD in the mid LAD with an unsuccessful wiring (Figure 4).
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case_images: Case 6. Left anterior oblique (LAO) cranial view of left coronary angiography showing spontaneous coronary artery dissection of left circumflex artery (LCx) (arrows).
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case_images: Left heart catheterization showed a SCAD involving the LCx with TIMI grade 3 distal flow (Figure 5).
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case_images: Case 7. Right anterior oblique (RAO) cranial view of left coronary angiography showing spontaneous coronary artery dissection of first diagonal branch (D1) of left anterior descending (LAD) artery (arrows).
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case_images: Coronary angiogram showed an abnormality in the diagonal branch of the LAD (mid D1 radiolucency) concerning for thrombus versus dissection (Figure 6).
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case_images: Case 8. Right anterior oblique (RAO) caudal view of left coronary angiogram showing spontaneous coronary artery dissection of mid left anterior descending (LAD) artery with intramural hematoma (arrows).
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case_images: Coronary angiogram showed SCAD of the mid portion of the LAD with large intramural hematoma compromising the blood flow to the first and second diagonal branches of the LAD with TIMI grade 3 flow into distal vessel (Figure 7).
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case_images: Case 9. Right anterior oblique (RAO) caudal view of left coronary angiography showing spontaneous coronary artery dissection of proximal left anterior descending (LAD) artery with compromised blood flow to diagonal branches (arrows).
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case_images: Emergent catheterization showed a dissection of the proximal LAD after the first 2 septal perforators with evidence of luminal compromise by a hematoma (Figure 8).