Simultaneous and spontaneous multivessel coronary artery dissection presenting as congestive heart failure.

Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia. Multivessel SCAD is much rarer than single vessel involvement and acute coronary syndrome is the most frequent clinical presentation of a patient with SCAD. The patient in this report had SCAD in both the left anterior descending and right coronary arteries at the same time. However, the clinical manifestation was not acute coronary syndrome but rather congestive heart failure. Successful angioplasty and stent placement was performed and the symptoms of congestive heart failure were successfully resolved with medical treatment.