摘要:Introduction. Myocardial infarction (MI) is characterized by a critical myocardial ischemia followed by an irreversible myocardial cell damage or death. Case report. We presented two similar clinical cases with the ST segment elevation myocardial infarction (STEMI) diagnosis due to a prolonged coronary artery spasm, but with different treatment options due to different basic patophysiological supstrates and clinical presentations. Conclusion. Coronary artery spasm is a very complex pathophysiological entity with a different medication therapy management. Although the percutaneous coronary intervention can be the first choice, the treatment strategy should be carefully planned