Chest pain is a common clinical complaint. Electrocardiograms must be included in diagnosis, and the priority should be given to cardiovascular diseases that may lead to sudden death. The case described here is a 44-year-old middle-aged woman who presented to the emergency room with unendurable chest pain. After continuous follow-up ECG and blood tests, she was diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS). The result of coronary angiography correspond to sponta-neous coronary artery dissection (SCAD). The purpose of this article is to emphasize the possibility of SCAD in acute coronary syndrome in middle-aged women without coronary artery disease risk fac-tors. SCAD is characterized by intimal tear, intramural hematoma, and false lumen formation, which can obstruct coronary blood flow and cause myocardial ischemia with chest pain. Since the etiology of SCAD is different from obstructive coronary artery myocardial infarction, their medical treatments must be carefully evaluated through clinical patient conditions to reduce the risks of invasive proce-dure. In this case, early and correct diagnosis was made to reduce invasive procedure, and appropriate medication therapy were applyed to achieve the purpose of relieving the patient’s symptoms, prevent-ing complications and recurrence. Through this case report, it is hoped that healthcare professionals will improve awareness of caring for patients with spontaneous coronary artery dissection.
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