Global coronary arteries spasm in a young patient

BACKGROUND: Coronary artery spasm is a transient narrowing of coronary arteries that slows or stops blood flow through the artery. CASE REPORT: We present a 42-year-smoker man without any medical problem who developed syncope. Coronary angiography revealed diffuse significant narrowing of proximal left anterior descending artery (LAD), 90% osteal stenosis of large obtuse marginal (OM), 90% diffuse narrowing of proximal right coronary artery (RCA), which was relieved by intracoronary administration of nitrate. He was discharged on calcium channel blockers and nitrates but one month later developed syncope again and died. CONCLUSION: Multivessel coronary artery spasm should be considered in young smoker patients without any other coronary risk factors who present with syncope.