Sinus Node Ischemia—A Unique Presentation

Sinus node dysfunction, as the sole manifestation of an acute coronary syndrome, is rare. We report a case of ischemic dysfunction of the sinus node in a patient who had previously undergone coronary artery bypass grafting for triple vessel disease. Intermittent rest angina with a junctional rhythm was noted in spite of patent grafts to all three vessels, which resolved after percutaneous revascularization of the right coronary artery.