Coronary vasospasm presenting as Prinzmetals angina and life threatening Brady-arrhythmia independently at different times.

A 65-years-old female presented with features suggesting acute coronary syndrome, initially as non STEMI and later as classical Prinzmetal's angina. While being treated she also had recurrent episodes of dizziness and cardiac arrest due to complete heart block and asystole. These episodes occurred while on nitroglycerine infusion and were not accompanied by chest pain or ST-T segment changes. Coronary angiography revealed evidence of reversible multi-vessel coronary spasm. Electrophysiological studies were normal. She was treated with nitrates and calcium blockers and a permanent pacemaker implantation.