Upon his admission in sudden arrest, ECG was in ventricular fibrillation. Nevertheless, repeated ECGs during resuscitation showed a transient ST-segment elevation in the inferior leads, with a QRS-ST-T “shark fin” pattern and frequent R/T ventricular premature contractions (VPCs) (Fig. 2). He was successfully resuscitated and stabilized then transferred to the catheterization laboratory. Coronary angiogram revealed significant narrowing of the RCA at the previously diseased segment (Fig. 3), slightly improving after intra coronary nitroglycerin (Fig. 3). The LAD lesion was stable. Primary stenting of the RCA lesion was performed (Fig. 3). Furthermore, due to the potentially lethal ventricular arrhythmia that complicated the RCA spasm, the relatively diffuse spasm on the RCA and the fear of future spasm in the non-stented segment, we decided to implant an intracardiac defibrillator (ICD). After an uneventful stay, the patient was discharged on calcium channel blockers (CCB) and dual antiplatelet therapy (DAPT).