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We report the case of a 33-year old woman with a recurrent spontaneous coronary artery dissection (SCAD). Primary SCAD involving left anterior descending coronary artery (LAD) was managed conservatively. She underwent repeated coronary angiography for progression of exertional dyspnoea (NYHA II-III, CCS 0) 6 weeks later and new SCAD of the proximal right coronary artery (RCA) was found. An attempt at PCI on LAD led to retrograde progression of dissection into the left main coronary artery (LM). She hemodynamically deteriorated and complained of chest pain due to compromised LM flow (TIMI I). She underwent successfully “bail-out” triple CABG (on LAD, obtuse marginal branch - OM, and posterior descending artery - PDA). The patient is virtually asymptomatic (NYHA II, CCS 0) at 1-year follow up; however with borderline LV function (LVEF 45 %), and persisted apical and anteroseptal akinesis. [ABSTRACT FROM AUTHOR]