Figure 1 Cardiac magnetic resonance (CMR) findings in a 53 year old male patient who presented with 2 mm ST segment elevation in the anterior ECG leads. He received intravenous thrombolysis within two hours of the onset of pain and had rapid resolution of the ST segment changes. His peak creatine kinase was 495 IU. He had no symptoms post‐infarction. His exercise tolerance test was positive. Perfusion images were normal at rest (A) but showed a large transmural inducible perfusion defect in the antero‐septal wall at stress (B). The CMR study showed no evidence of scar on the late gadolinium enhanced images (C). Subsequent x ray angiography confirmed a proximal high grade lesion in the left anterior descending coronary artery, which was treated by percutaneous coronary intervention.