Spontaneous coronary artery dissection--a case report and review of the literature.

Spontaneous coronary artery dissection remains an extremely rare cause of myocardial ischemia and infarction. The clinical picture of spontaneous coronary dissection is often sudden cardiac death or fatal myocardial infarction. This report describes a previously healthy woman who developed spontaneous coronary artery dissection. She presented with sudden onset of chest pain and was found to have evidence of acute inferior wall myocardial infarction. She received streptokinase immediately after admission to the coronary care unit. Coronary angiographic studies revealed a linear dissection involving the proximal and mid segments of the right coronary artery.