A 60-year-old man came to hospital with precordial pain lasting two hours. The ECG revealed a subepicardial lesion current compatible with an inferior AMI, a pronounced J-point depression together with a descending D-ST in leads V1-V2 and a horizontal D-ST in V3 to V5. Fibrinolytic treatment with tenecteplase and lidocaine was administered for extrasystolic ventricular tachycardia. One and a half hours later the ECG, recorded without pain, revealed a marked J wave in leads V1-V2 and no ST segment shift. One day later the ECG revealed an inferior T-wave inversion, a J-wave in leads V1-V2 and a concave E-ST with positive T-waves in leads V2 to V4. Creatinine kinase rose to 1,143 U/l (with a MB fraction of 102). An echocardiogram revealed inferobasal akinesia. The clinical course in hospital was uneventful. Four years after discharge the ECG showed a J wave in inferior and anterior leads, and a concave E-ST with positive T wave in leads V2 to V4 suggestive of a PRRS.