It was followed nearly 12 hours later by a quake measuring 6.9 magnitude and a string of powerful aftershocks.

The picturesque island next to holiday hotspot Bali was already reeling from two deadly quakes on July 29 and August 5 that left hundreds of thousands homeless.

Ten people were killed in the quake Sunday evening, mostly by falling debris, with four deaths in eastern Lombok and six on the neighbouring island of Sumbawa, according to the national disaster agency.

Two more Lombok residents died of heart attacks after the morning quake, it said.

Some two dozen people were injured and more than 150 homes and places of worship were damaged, the agency said.

"When the earthquake happened most people were outside their homes or at shelters so there have not been that many fatalities" compared to the August 5 tremor, said national disaster agency spokesman Sutopo Purwo Nugroho.

"The trauma because of the earlier quake on Sunday (morning) made people prefer to stay outside," he added.

Officials have evacuated some patients from a hospital in Sumbawa island and in Lombok's capital Mataram for fear of worse destruction.

Blackouts have hit much of Lombok, according to Sutopo, who posted pictures of cracked roads and video footage of a large fire that broke out in a village on Sumbawa.

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