SCAD classification is based on coronary angiography. In the past, angiographically coronary dissections could be graded according to the National Heart, Lung, and Blood Institute classification system. This system grades coronary dissections according to angiographic appearance as types A-F implying the presence of intimal tear (78)(Figure 8). Only recently, the Vancouver group of Jacqueline Saw have proposed another classification which is currently being used by interventional cardiologists. Hence, depending on the angiographic features three different types of SCAD have been described (43,56). Furthermore the ESC position paper 2018 has introduced an additional forth type (46): this is often misinterpreted with type 2 since they are very similar. Type 2 is the most frequent variant reported (52-67%) (56,79). The current classification is reported in figure 9. Illustrations modified by ( 80) and ( 81).