Spontaneous coronary artery dissection: an uncommon primary presenting feature of fibromuscular dysplasia

Spontaneous coronary artery dissection is a rare but increasingly recognised cause of acute coronary syndrome particularly in young women, accounting for up to 25% of acute coronary syndrome cases in women under 50. It is, however, an uncommon primary presenting pathology of underlying fibromuscular dysplasia. We present the case of a woman in her 40s, with no significant medical history, presenting with anterior ST elevation myocardial infarction, identified as spontaneous coronary artery dissection on invasive coronary angiogram with an underlying aetiology, and subsequent diagnosis, of fibromuscular dysplasia being established on MR angiography.