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An 18-year-old school boy was admitted to emergency department for left sided chest pain following trauma. He had several deep cut injuries over his left forearm and scalp as well as a superficial cut injury over left lateral chest. He had a typical ischaemic type of chest pain after the incident. The pain lasted only about a minute. It was associated with palpitations. A similar, less intense episode of pain followed a few minutes later. Except for the cut injuries his physical examination was unremarkable. The ECG showed T inversions in V3-V6 (Figure 1). Troponin I was positive with a value of 4.09. The chest radiograph and 2-D echocardiography were normal. With the history of classical anginal chest pain, positive troponin and dynamic ECG changes, a diagnosis of non ST elevation myocardial infarction was made.

An acute coronary event due to vasospasm in a young healthy male with normal epicardial vessels