A case of 44-year-old women with episodes of chest pain with ST-T segment elevation and paroxysmal atrioventricular complete block with syncopal episodes is presented. Coronary angiography did not reveal atheromatous lesions. A patient was treated with nitrates and calcium channel blockers. However syncopal episodes with A-V block reoccurred. A single-chamber (ventricular demand) pacemaker was implanted. A six month follow-up was uneventful.