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The large and multiple spontaneous coronary artery dissections of a 54-year-old man Coronary angiography demonstrated spiral dissection of right coronary artery (RCA) and of proximal and second diagonal branch the left descending coronary artery (LAD) (Figs. 1 and 2), and significant obstruction of the proximal segment of LAD. Revascularization was performed with LIMA to LAD and saphenous vein to distal RCA grafts. Fig. 1. Right coronary artery, LAO projection. Arrows delineate the extent of the spontaneous dissection. Fig. 2. Left coronary artery, RAO cranial projection. White arrows delineate the spontaneous dissection. Black arrow shows occlusion of left anterior descending artery (LAD, left descending coronary artery; LCX, left circumflex coronary artery).