Prinzmetal angina. Multifocal ischemia, recurrent AV block, and bradycardia with patent coronary arteries responsive to verapamil.

Coronary vasospasm may result in recurrent angina pectoris and cause acute myocardial infarction. The extent to which the "sudden death syndrome" occurs is unknown. The case described herein is unique in that the clinical features, including hypotension, AV block, and ventricular arrhythmias, were similar to those seen in myocardial infarction with a poor prognosis, yet infarction was not documented. In subsequent, long-term follow-up evaluation, chest pain has been recurrent, but despite close observation, no further major cardiac complications have been documented. Long-term use of verapamil has contributed to better control of clinical symptomatology.