Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction, primarily in young women. The etiology of dissections is still under discussion. Possible factors are inflammation, changes of flow dynamics, and preexisting intima lesions. We report on two young women, 49 and 30 years of age, who suffered and acute anterior wall infarction. Coronary angiography confirmed diagnosis of spontaneous coronary artery dissection of the LAD in the acute an subacute phase of acute myocardial infarction. The patients suffered no further cardiac events at long-term follow-up of up to 9 years.