Abstract
Recent studies demonstrate the relevance of apical ischemia in the pathophysiology of apical hypertrophic cardiomyopathy. This finding could explain why some patients may exhibit chest pain and dynamic ST-segment changes simulating an acute coronary syndrome. We present a paradigmatic case of apical hypertrophic cardiomyopathy with normal coronary arteries presenting with prolonged chest pain and ST-segment elevation myocardial infarction.