RESUMO
Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of myocardial infarction (MI), and its prevalence among women is increasing. Epidemiological information indicates that SCAD is responsible for one-third of MI cases in women of reproductive age. Little information is described on SCAD in elderly patients. The patient in the case presented here was an 81-year-old woman with a history of SCAD who presented with oppressive thoracic chest pain associated with electrical changes that derailed into ventricular fibrillation. Coronary angiography confirmed a SCAD recurrence, and conservative medical treatment was established. Different pathophysiological pathways have been proposed for SCAD extension or recurrence. Nonetheless, there is yet much to be discovered about this disease and its presentation in different age groups.