Recently, and after uneventful seven years since the index episode, the patient presented to the emergency department with nine shocks delivered by the ICD, corresponding to a malignant ventricular arrhythmic storm and preceded by the same chest pain. Coronary angiogram was carried and showed diffuse RCA vasospasm partially subsiding with intra coronary nitroglycerin, which unmasked a significant narrowing upstream to the previous stent. Successful stenting of the target lesion was performed. Again, optimal medical treatment with maximally tolerated anti-vasospastic agents (CCB and nitro derivatives) and DAPT was pursued.