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A 69-year-old man with a history of tobacco abuse was referred to our hospital with 3/10 chest pain for 12 hours, a normal ECG (Figure 1A) and a slight increase in cardiac enzymes. En route, he developed palpitations without increase in chest pain. On arrival his ECG showed atrial fibrillation with a ventricular response of 160 bpm (Figure 1B). After one hour on intravenous diltiazem infusion he converted to a junctional rhythm at 30--50 bpm with resolution of symptoms (Figure 1C). Cardiac catheterization with temporary pacemaker back-up revealed an occluded small non-dominant right coronary artery with mild left coronary atherosclerosis and collaterals to the right system (Figure 1D). Two-dimensional echocardiography revealed normal left and right ventricular function with a dilated

Isolated right atrial infarction from occluded non‐dominant right coronary artery