Abstract
ST-elevation criteria miss a substantial number of acute coronary occlusions, resulting in treatment delays and worse prognosis. The Aslanger pattern has been proposed as a new pattern that, despite not meeting the definition of ST-elevation myocardial infarction, represents an acute coronary occlusion. Therefore, patients with this pattern could benefit from early revascularization. The case of a man with acute chest pain is presented, whose initial electrocardiogram showed an Aslanger pattern. Due to the misdiagnosis at the primary care center and the emergency room, the patient did not receive timely optimal management. This case remarks the importance of recognition of this new pattern and its impact on decision-making in patients with acute coronary syndrome.