We report the case of a middle-aged female who presented with an acute inferior myocardial infarction treated with intravenous thrombolytics. Immediate coronary angiography demonstrated the presence of a spiral dissection and a large thrombus. After 1 week of anticoagulation the thrombus had resolved, but a large spiral dissection persisted. This was confirmed by intracoronary ultrasound. We then review the literature on spontaneous coronary arterial dissection.

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