VASOSPASM IN SMOOTH CORONARY-ARTERIES AS A CAUSE OF ASYSTOLE AND SYNCOPE

In a patient with proven myocardial infarction, coronary artery diseas e was excluded angiographically, Four weeks later the patient experien ced recurrent syncope of unknown cause. By means of Holter monitoring, ST-segment elevation with subsequent first-degree AV block progressin g to asystole and resulting in loss of consciousness were documented, Treatment with gallopamil and a VVI-pacemaker led to complete relief o f all symptoms, Hence, Prinzmetal's angina may be a rare cause of sync ope even in smooth coronary arteries. (C) 1997 Wiley-Liss, Inc.