Abstract
Spontaneous coronary artery dissection (SCAD) is an infrequently diagnosed cause of an acute coronary syndrome (ACS). In many cases, no clear precipitant is identified. In this case, we present a novel presentation of triple vessel SCAD in a patient presenting with viral encephalitis. Despite an initial conservative strategy, haemodynamic instability and involvement of the left main stem (LMS) ultimately necessitated emergent coronary intervention with a ‘shotgun’ LMS bifurcation strategy.