Posterior wall myocardial infarction (PWMI) accounts for about 1520% of all STEMIs and is usually seen in the context of inferior and/or lateral wall MI [2]. Isolated posterior wall MI are much less common, of about only 3.3% of all myocardial infarcts [1]. The clinical presentation of PWMI may not be very specific and is confusing even for a cardiologist. Moreover the lack of ST elevation in a standard 12lead ECG leads to missed or delayed diagnosis of a true PWMI. We are reporting a case of isolated PWMI in a 65 years old, previously healthy male patient, who presented with only gradual onset shortness of breath, who was later found to have 100% LCx stenosis. We have tried to emphasize some facts that may make the clinicians aware of a possible PWMI.

Keywords: ST Elevation Myocardial Infarction (STEMI); LCx; PWMI; Posterior ECG Leads V7 V8 V9; Right Coronary  Artery (RCA); Left Anterior Descending Artery (LAD); ST Depression; Dominant R Wave; Flip Test; Coronary Angiography (CAG); Troponin I; Percutaneous; Coronary Intervention (PCI); Stenting.