A young woman who presented with chest pain was shown with CT and selective coronary angiography to have spontaneous dissections of her left anterior descending and distal right coronary arteries. She was managed with enoxaparin, aspirin, clopidogrel and metoprolol: she was well with a normal stress echocardiogram fourteen months later. Surgical intervention or angioplasty and stent deployment may be avoided in such patients if they are clinically stable.
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