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We report an unusual case of spontaneous coronary artery dissection in a 59-year-old patient with autosomal dominant polycystic kidney disease who presented with mild intermittent chest discomfort during hiking. Coronary computed tomography angiography revealed an unexpected dissection flap in the left main coronary artery extending to the proximal part of the left anterior descending artery. After transcatheter placement of a coronary stent, the patient had no recurrent discomfort even during heavy exercise.

Mild-MG group patients have muscle oxidative metabolism similar to that of healthy control subjects, whereas moderate-to-severe-MG group patients have impaired V(max) during exercise and a noticeable shift to glycolytic metabolism, but these abnormalities are reversible after thymectomy.

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