Spontaneous coronary artery dissection presented as posterior ST-Elevation myocardial infarction.

A 48-year-old female, head nurse in a neighboring hospital, during her morning occupation at the hospital, felt an acute pain in the mid-chest, with radiation in her left shoulder. She was a non-smoker, with no cardiovascular history or predisposing factors for atherosclerotic disease, under treatment with thyroid hormone replacement due to hypothyroidism. Although a mild ST-segment depression was revealed at the 12-lead electrocardiogram left precordial leads, the appearance of an ST-segment elevation at the posterior leads V7, V8, and V9 was in favor of posterior – lateral ST-Elevation Myocardial Infarction (STEMI) [Figure 1].