A 59 year old man with history of smoking, hypertension, diabetes mellitus, and hypercholesterolemia presented suddenly with numbness and weakness of both upper limbs. A few minutes after that he felt an intense and oppressive chest pain accompanied by profuse diaphoresis, severe hypotension, bradycardia, and low level of consciousness. No elevated damage cardiac markers or electrocardiographic changes were registered. Aortography ruled out an aortic dissection whereas coronary angiography showed a moderate stenosis in the …