The authors report two new cases of spontaneous coronary dissection and discuss the real frequency of this disease as well as their generally reported poor prognosis. One case was a 32-year-old female migraine-sufferer treated by beta-blockers, who developed a rudimentary anterior myocardial infarction. The other case was a 43-year-old man who presented with a threatened anterior myocardial infarction without myolysis documented by cardiac enzymes. Both patients were smokers and both had an excellent outcome, clinically and on stress tests, with a follow-up on medical treatment alone of thirty months for the first case and fourteen months for the second case. These two new cases had a good prognosis, in contrast with the majority of cases published.