Spontaneous coronary artery dissection: to treat or not to treat--2 atypical cases and a review of the literature.

Spontaneous coronary dissection is an unusual cause of acute coronary syndrome and sudden death, with a predilection for otherwise healthy young women. Presentation during the peri-partum period accounts for a quarter of the cases. We describe 2 cases of spontaneous coronary dissection with some atypical features. Both patients differed in their demographics, clinical presentations, and management strategies. Posited pathogenetic mechanisms for spontaneous coronary dissection are varied and remain poorly understood. Optimal management strategies depend on the vessels involved and the presence of ongoing symptoms. Patients who survive to presentation typically have a good prognosis.