Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome in young persons, rarely found in men. There are currently no known direct causes of this condition, although some correlations have been found. We report the case of a 45-year-old man with unstable angina pectoris secondary to spontaneous diffuse spiral dissection in the right coronary artery. In addition, the patient was diagnosed with other autoimmune related diseases, for example hypothyroidism, chronic atrophic gastritis, lung emphysema, which suggesting that autoimmune mechanism is an important mechanism for the occurrence of SCAD.