DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.020

Pages: 1850-1853

Spontaneous coronary artery dissection (SCAD0 is a non-atherosclerotic cause of acute coronary syndrome that predominantly affects women, with emotional or physical stress recognized as one of its most consistent precipitating factors [1],[2]. We report a case of extensive SCAD, involving the left main coronary artery extending into the proximal-mid left anterior descending artery, in a 30-year-old man with a one-year history of widowhood and a background of tobacco smoking. He presented with three months of progressive exertional angina before diagnosis was confirmed on coronary angiography and intravascular ultrasound (IVUS). Given the absence of significant atherosclerotic risk factors beyond smoking, and the presence of sustained psychological distress following the loss of his spouse, chronic emotional stress is proposed as the most probable trigger in this case. This report discusses the pathophysiological link between emotional stress and SCAD, and argues for greater clinical attention to psychosocial history in young patients presenting with unexplained chest pain.