Reversible sick sinus syndrome due to sinus node artery ischaemia in an elderly woman: a case report

Despite no chest pain or ST changes, the acute presentation and multiple coronary risk factors suggested an ischaemic aetiology. Intermittent right coronary artery impairment, bradycardia-facilitated collateral flow, and repolarization abnormalities likely obscured typical ischaemic signs. This case highlights the importance of ischaemic evaluation before pacemaker implantation, even in elderly patients.