We present the case of a 45-year-old Iranian woman with acute dyspnea and atypical chest pain who was referred to our emergency department. She had a past history of neurosis and relatively controlled hypertension. Her vital signs were stable on admission, except for blood pressure, which was 160/90 mmHg. A standard ECG showed diffuse, new ST-segment elevation (about 3 mm) in the anterolateral (V4-V6) and the inferior leads (II, III, and aVF) with normal sinus rhythm and transient arrhythmias (atrioventricular dissociation, infrequent premature ventricular contractions [PVCs], and complete heart block) (). Findings on laboratory tests were within the normal range, except for marked elevation in the level of cardiac enzymes (creatine kinase [CK] MB and troponin). The level of CK MB was about 151 UI/L (normal level: < 25UI/L) and the level of troponin T was about 3 ng/mL (normal level: < 0.02 ng/mL). Emergent coronary angiography was performed, and significant lesions wrapped around the left anterior descending artery at the proximal and the middle parts were observed. Left ventriculography showed left ventricle systolic dysfunction (left ventricular ejection fraction [LVEF] of about 30% - 35%) and apical ballooning pattern (severe akinesia in apical segments and normal motion in basal segments), and mild mitral regurgitation (MR) (). Echocardiography also showed the same pattern that was consistent with findings for TCMP. Temporary pacemaker was not inserted as there was recovery from CHB and AV dissociation after 5 days of admission, and the patient was stable during admission. The patient was treated with aspirin, angiotensin-converting enzyme inhibitor, diuretic, clopidogrel, and nitrates, but beta blockers were not administered due to presence of CHB. The patient’s hospital course was uncomplicated, and she was reevaluated after 7 days. Echocardiographic data showed improvement of apical wall motion abnormality, and LV ejection fraction had increased to 45% and ECG showed normal sinus rhythm with a heart rate of about 73 beats/min with no arrhythmia; the patient was discharged from the hospital. Repeated echocardiography after 3 weeks showed normal LV systolic function; the LVEF was about 55% with no wall motion abnormality. ECG showed normal sinus rhythm and a narrow complex QRS. Her heart rate was about 75 - 80 beats/min with asymptomatic Wenckebach block. Maximal exercise stress test and perfusion scan performed after 1 month from the acute event did not show any ischemia; hence, revascularization was not recommended. During the 3 years of follow-up (2012 - 2014), no events occurred. However, after the second year, a Wenckebach block occurred, with an acceptable heart rate of 72 beats/min on ECG, and echocardiography data were normal. At the third year of follow-up, a first-degree atrioventricular block was noted with a heart rate of about 70 beats/min on ECG () and echocardiography findings were normal (LVEF=55%); no complaint or symptom was reported during this time, and the patient was treated with diuretic and enalapril (for hypertension), aspirin, atorvastatin.