Over the last decade, spontaneous coronary artery dissection (SCAD) has garnered much attention as a significant cause of acute coronary syndrome (ACS) and sudden cardiac death in women without classic cardiovascular risk factors . SCAD has been mostly studied in the West, with little recognition in Asia leading to under-diagnosis and under-representation . In this review, we highlight two distinct cases occurring at our center in Singapore, affecting two Singaporean women of Malay and Chinese descent. These 2 cases highlight that pregnancy-associated SCAD is neither the most common nor only manifestation of SCAD . Through review of the literature, we emphasize the heterogeneity in case presentation paying particular attention to SCAD and its association with connective tissue disorders such as fibromuscular dysplasia . SCAD remains a diagnostic challenge for many cardiologists, here we shed light and dispel myths surrounding coronary angiography and review the use of intracoronary imaging . The successful treatment of this unique group of patients requires a high index of suspicion, and management within a multidisciplinary team . The development of a recovery program with access to support groups, allied health, and cardiac rehabilitation is paramount in improving outcomes for these patients in the long term . Further research and studies in our Asian population will help to enhance our understanding of this disease and develop practices to best manage our patients.