A 43-year-old man was admitted to hospital with severe precordial pain lasting one hour. The ECG showed mild inferior E-ST, prominent J wave in V1-V2 and marked D-ST in leads V1 to V5. Diagnosed with inferoposterior AMI, the patient received thrombolytic treatment with reteplase. One hour later the ECG revealed an incomplete BRD, an overt J wave (R') in leads V1-V2 and no ST-segment deviations. There were also high R-waves affecting the initial part of the QRS complex and acuminate T-waves in leads V2-V3, suggesting the diagnosis of subsequent superimposed AMI. Eight hours after admission the ECG revealed a T-wave inversion in leads III and aVF, a J-wave in leads V1-V2 and a concave E-ST with positive T-wave in leads V1 to V4. Three days later the ECG revealed a J-wave, a concave E-ST and a positive T-wave in leads V2 to V5 suggestive of PRRS. Creatinine kinase rose to 4,999 U/l (with a MB fraction of 254). An echocardiogram revealed inferobasal and apical akinesia. Coronary arteriography revealed a 90% stenosis in the middle third of the right coronary artery and 60% stenosis in the proximal portion of the circumflex artery. Following stenting of the right coronary artery, the patient has been asymptomatic for three years.