Simultaneous occurrence of spontaneous coronary artery dissections of the left anterior descending and right coronary arteries in acute myocardial infarction.

Spontaneous coronary artery dissection (SCAD) is a rare and often fatal cause of ischemic heart disease that occurs predominantly in young or middle-aged patients who are otherwise healthy. Therefore, the accurate diagnosis of SCAD and initiation of appropriate treatment may be life-saving. Although recent case reports have described patients with SCAD who exhibited multiple coronary dissections in addition to the culprit lesion, the authors could not determine whether the multiple dissections occurred simultaneously or at different times. In this report, we describe a case involving the simultaneous occurrence of multiple SCADs in the right coronary artery and left anterior descending artery. Intravascular ultrasound helped us to confirm the diagnosis of multiple SCADs, confirm their simultaneous occurrence, and navigate the guidewire into the true lumen. <Learning objective: In general, spontaneous coronary artery dissection (SCAD) is a single-vessel disease; the left anterior descending artery is the vessel most often involved, followed by the right coronary artery. However, the possibility of other coronary dissections distant from the culprit lesion should be considered in patients who present with an acute coronary syndrome due to SCAD. A prompt diagnosis and patient-tailored management can reduce morbidity and mortality in this population.>.