Tension pneumothorax presenting as ST segment elevation: Look, Listen, Act!

We present a unique case of a patient with a tension pneumothorax that presented with electrocardiogram (ECG) characteristics typical for ST segment elevation myocardial infarction. The clinical diagnosis was clinched by focused physical examination. Treatment of the pneumothorax lead to resolution of the electrocardiographic abnormalities. Our experience from this unique case is useful for cardiologists and critical care physicians who encounter these patients routinely.