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4 months male child presented with failure to thrive. On general examination child had normal O2 saturation with characteristic elfin facies. Further evaluation of the patient showed major manifestations of Williams syndrome in form of supravalvar aortic stenosis, branched pulmonary artery stenosis along with cardiomyopathy. Although the entity is known, this article shows comprehensive diagnostic workup with the aid of multimodality imaging techniques. The genetic diagnosis of Williams syndrome was confirmed using fluroscent in situ hybridisation techniques (FISH). In this patient most of the manifestations of elastin vasculopathy were noted in the form of involvement of ascending aorta, pulmonary arteries and myocardium. We also want to emphasis the importance of echocardiography in newborn patients with dysmorphic facies as Williams syndrome can be easily missed in neonatal period.

Refractory coronary vasospastic angina is prone to fatal outcomes. Therefore, it is crucial that the most suitable treatment strategy be promptly elected so as to avert further cardiac complications. Here, authors present the clinical course of profound refractory coronary vasospastic angina in a 50-year-old man. Authors elected to manage the patient through stent implantation. Despite, a complication of perforation followed by refractory coronary vasospasm, authors elected to implant a second stent to relieve the patient from all symptoms.

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