We report the case of a myocardial infarction in the post-partum period due to a spontaneous coronary artery dissection. The role of intracoronary imaging was critical: OCT imaging led us to formulate the right diagnosis.OCT imaging revealed a multiple coronary artery dissection in the left main non-detectable on angiography and in the circumflex, with evidence of coronary hematoma in the circumflex and left anterior descending. Beside dissection, OCT showed evidence of a thrombus near the coronary tear in the left main. Our invasive OCT-based strategy proved to be non-harmful and gave an excellent clinical result in the clinical context of a spontaneous multivessel coronary dissection with left main involvement in a rare connective tissue disorder.

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