We think of spondaneous coronary artery dissection as being a cause of peripartum myocardial infarction - but about 90% of cases are not pregnant. It can be precipitated by valsalva type manoeuvres. There is an association with exercise, especially in male users. There are case reports linking SCAD with drugs, and emotional stressors.
Thrombolysis is considered safe and apparently effective but generally avoided, because can cause rupture leading to tamponade. Dual antiplatelet therapy probably indicated - but may cause menorrhagia as is used for women of child bearing age.
https://heart.bmj.com/content/103/13/1043
http://www.emdocs.net/spontaneous-coronary-artery-dissection/
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