Double-Vessel Involvement: A Case Report of Simultaneous Left Anterior Descending Artery (LAD) and Right Coronary Artery (RCA) Spontaneous Coronary Artery Dissection Causing Acute Coronary Syndrome

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS).Here, we describe a case of multivessel SCAD in a 48-year-old Indian male who presented with ACS.His echocardiography confirmed a picture of moderate ischemic cardiomyopathy complicated by the presence of an apical clot, and coronary angiography confirmed SCAD in both the left anterior descending artery (LAD) and right coronary artery (RCA).He was also found to have an occlusion of the subclavian artery, raising the possibility of vasculitis, including Takayasu arteritis.The patient was managed conservatively with guideline-directed medical therapy for ACS and heart failure, along with anticoagulation for the left ventricular (LV) apical thrombus.He remained hemodynamically stable without recurrent ischemia or arrhythmias and was discharged in stable condition.This case highlights the importance of considering SCAD in ACS presentations and evaluating for associated arteriopathies or vasculitis in patients with multivessel involvement.