Multivessel spontaneous coronary artery dissection and Crohn's disease

Spontaneous coronary artery dissection (SCAD) may be a cause of up to 1-4% of acute coronary syndrome overall, occurring mainly in young women, less than 50 years old, with no classical risk factor for CAD, especially during the postpartum period or associated with inflammatory disease. The clinical presentation varies from no symptoms to typical angina and sudden cardiac death. Multivessel coronary artery dissection is a very uncommon condition. We report the case a of 72-year-old woman, affected by Crohn's disease, who presented to the emergency department for mental confusion and right brachial hyposthenia, increased myocardial injury biomarkers, and mild ST-elevation at ECG. Coronary angiography was performed showing long dissection of the left anterior descending coronary artery and, simultaneously, dissection of the first obtuse marginal artery; final diagnosis was multivessel SCAD in Crohn's disease.