Multiple coronary artery dissections in old age. A unique case.

A 70-year-old man died of alcoholic cirrhosis and long-standing pulmonary emphysema. Multiple independent dissecting aneurysms involved the distal epicardial branches of the right and left coronary arteries, but spared their proximal trunks. These dissections extended distally from vascular branch points in association with acute and chronic medionecrosis. Iatrogenic trauma superimposed on preexisting medial weakness may have accounted for what is, to our knowledge, a unique presentation of a rare condition.