Spontaneous coronary artery dissection occurs with and without periadventitial inflammation.

Dissection of a coronary artery not associated with aortic dissection or trauma is a rare condition that occurs most frequently in peripartum or postpartum women. It has been suggested that localized periadventitial inflammation, often found adjacent to these lesions, may represent a primary vasculitis which causes dissection. Two cases of spontaneous coronary artery dissection are described, together with a brief review of previously published cases. Based on this review, we conclude that periadventitial inflammation is reactive, rather than primary, in nature.