Spontaneous coronary artery dissection is an uncommon clinical condition. It has most often been described in healthy peripartum women with no risk factors for atherosclerosis. We report the case of an elderly hypertensive man who presented with unstable angina and impaired left ventricular function. Coronary angiography revealed dissection of the left anterior descending as well as the circumflex arteries. This case supports the occurrence of spontaneous coronary dissection as a cause of acute coronary syndromes in patients with underlying atherosclerosis, which has rarely been reported.
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