Multivessel Spontaneous Coronary Artery Dissection and Myocarditis: A Rare Case Highlighting the Value of Multimodality Cardiac Imaging

Spontaneous coronary artery dissection (SCAD), once considered too rare to study, is now recognized as an important nonatherosclerotic and nontraumatic cause of myocardial infarction, especially in young women. However, it is often challenging to differentiate from alternative etiologies of chest discomfort, such as atherosclerotic acute coronary syndromes or myocarditis. Here, we describe the unique case of a young woman who presented with an acute chest pain syndrome and was found to have co-occurring myocarditis and multivessel SCAD. The use of multimodality imaging studies to include transthoracic echocardiogram (TTE), cardiac magnetic resonance imaging (MRI), coronary computed tomography angiography (CCTA), invasive coronary angiography (ICA), and intravascular ultrasound (IVUS) delivered the confirmation of concomitant diagnoses which were consistent with the clinical presentation. This case highlights the critical role of multimodality imaging in the diagnosis and management of coexistent cardiac pathologies.