This is the case of a 53-year-old male patient without any known cardiovascular risk factors who suffered a cardiopulmonary arrest at this working place. First asystole rhythm reported and electrical activity without a pulse. A total of 5mg of adrenalin were administered. Pulse was recovered after 20min performing advanced CPR maneuvers. The first ECG performed revealed the presence of ST-segment elevation on leads I, III, and aVF that resolved spontaneously. At our hospital, a transient ST-segment elevation could be seen on leads V3, V4, and V5 (Fig. 1). The emergency coronary angiography performed showed diffuse spasm in the coronary arteries with subtotal stenosis (TIMI flow grade 1) in the proximal left anterior descending coronary artery (Fig. 2). The spasm resolved with intracoronary nitroglycerin (Fig. 3) with final TIMI flow grade 3 in the 3 major vessels. The patient progressed to severe hypoxic-ischemic encephalopathy.

Fig. 1

Fig. 2

Fig. 3