A case of spontaneous isolated dissecting aneurysm of the left main and anterior descending branches of the left coronary artery in a 42-year-old woman is described. The patient survived the dissection, and resultant myocardial infarct with cardiogenic shock was treated with an orthotopic cardiac transplant. She died from a bilateral pneumonia caused by Candida tropicalis 3 weeks later. Spontaneous isolated dissection of a coronary artery is rare and usually described in necropsy studies. To our knowl edge, this is the third report of an isolated primary dissecting aneurysm of a coronary artery treated by an orthotopic cardiac allograft. It is likely that surgical pathologists will encounter this entity more frequently in the future due to involvement in trans plantation teams. Int J Surg Pathol 2(3):227-230, 1995
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