eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-01-14 9 3 172 179 10.12691/ajmcr-9-3-11 AJMCR20219311 article Pramod Theetha Kariyanna 1 Harshith Priyan Chandrakumar 2 Yuvraj Singh Chowdhury 2 Apoorva Jayarangaiah 3 Sushruth Das 4 Amog Jayarangaiah 4 Moro O. Salifu 4 Isabel M. McFarlane isabel.mcfarlane@downstate.edu 4 Division of Interventional Cardiology Fellow, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel, New York City, New York-10025 Division of Cardiovascular Disease, Department of Internal Medicine, State University of New York-Downstate Medical Center, Brooklyn, New York, USA Department of Internal Medicine, Albert Einstein College of Medicine, NYC Health and Hospitals/Jacobi Medical Center, Bronx, New York-10461, USA Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, U.S.A. Spontaneous coronary artery dissection (SCAD) is a cardiac emergency and an uncommon cause of acute coronary syndrome (ACS) with a higher predominance in younger women. It is a non-traumatic, non-atherosclerotic lesion found to be associated with pregnancy, inflammatory disorders, connective tissue diseases and substance abuse. Our patient was a young woman with a chronic marijuana smoking history who was found to have a NSTEMI. Initial angiogram showed triple vessel disease involving left anterior descending artery (LAD), left circumflex artery (LCX) and obtuse marginal artery (OM). A repeat angiogram notably showed spontaneous progression with dissection in all three vessels attributable to substance abuse. We present you this rare occurrence of triple vessel SCAD secondary to marijuana with a literature review and discussion. http://pubs.sciepub.com/ajmcr/9/3/11/ajmcr-9-3-11.pdf marijuana coronary artery dissection risk factors