Background: Spontaneous coronary artery dissection is one of the rare causes of Acute coronary syndrome. Clinical presentation of the disease is variable in pattern and severity related to extent and development of rate of dissection. Initial reports on this condition were scarce as they were based on postmortem examination of fatal cases. Currently, Coronary angiography is the most widely used diagnostic technique in this condition. SCD may occur as an isolated phenomenon (I-SCD) or associated with coronary artery disease (A-SCD). Management depends on the clinical presentation and the results of coronary angiography.

Methodology: Reviewed meticulously 38,462 patients consecutive coronary angiogams retrospectively which were done between august 2010 to february 2014 using SCD definition8 as defined for the study. Patients medical records were analysed thoroughly for clinica and demographic data.

Results: 57 Patients of spontaneous coronary artery dissection were identified after review of 38,462 coronary angiograms. Fifty four (94.7%) of study population were males. Mean age was 51.2 ± 10.6years. We found 29.8% of patients with hypertension, 8.8% obesity, 29.8% diabetes mellitus, 49.1% dyslipidemia, 54.4% old IHD and 77.2% smoking history. No patients were in peripartum period in the study. 45(73.7%) of them presented with STEMI, 4(7%) of them with NSTEMI.

Conclusion: SCAD is a rare condition with prevalence rate of 0.14.It is seen commonly in middle and elderly age group male population with predisposing factors for CAD. SCD presents predominantly as ACS. The diagnosis of SCAD is made principally with invasive coronary angiography.