This case report describes the devastating consequences of
spontaneous coronary dissection in a 36-year-old female patient.
Surgical revascularization was attempted, but diffuse myocardial
infarction developed. The patient was bridged to heart transplantation
but died secondary to multiple organ failure. To our knowledge, this is
the only reported case of spontaneous dissection of the three main
coronary arteries due to severe cystic medial necrosis.