The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection.

(Opening paragraph) A 69-year-old woman with a history of treated hypertension, presented with sudden onset chest pain, at rest, and evidence of ST-segment elevation in the inferior leads of a 12-lead electrocardiogram. Urgent coronary angiography demonstrated an abrupt lumen calibre reduction extending from segment 2 of the right coronary artery (RCA) into the posterior descending artery, with preserved Thrombolysis In Myocardial Infarction (TIMI) 3 flow (Fig. 1A). The postero-lateral branch of the RCA was sub-totally occluded. Having confirmed patency of the infarct-related artery and complete resolution of the patient's symptoms, we proceeded to evaluate the RCA with OCT.