Hundreds of homes were damaged

Hundreds of houses were damaged and major highways were cracked in the magnitude 6.2 quake, centred 48km (30 miles) south-west of San Jose.

The tremor took place before the end of the Ibero-American summit, attended by leaders from 20 countries.

None of the leaders were hurt, although some were reported to have fled their hotel rooms.

Heart attacks

"We jumped from the bed like two cats," said Panama's first lady, Vivian de Torrijos, AP news agency reports.

"We're going to be able to remember the summit with something like that."

The quake hit during the Ibero-American summit

"I thought it was a train going through a station," said Spain's King Juan Carlos.

"I went back to sleep."

The Ecuadorian president, Lucio Gutierrez, said when he was woken by the shaking, he went and stood under a doorway for protection.

The authorities said three of the casualties had died from heart attacks and a 32-year-old Italian had been killed in a tremor-related motorcycle accident.

Falling trees knocked out power to the area around Quepos and the beach town of Jaco, a spokeswoman for the National Emergency Commission said.

The police station on the Pacific island of Damas reportedly collapsed.