Computed tomography angiographic demonstration of an unexpected left main coronary artery dissection in a patient with polycystic kidney disease.

We report an unusual case of spontaneous coronary artery dissection in a 59-year-old patient with autosomal dominant polycystic kidney disease who presented with mild intermittent chest discomfort during hiking. Coronary computed tomography angiography revealed an unexpected dissection flap in the left main coronary artery extending to the proximal part of the left anterior descending artery. After transcatheter placement of a coronary stent, the patient had no recurrent discomfort even during heavy exercise.