A woman in her 50s with a history of hypertension, insulin-dependent diabetes, dyslipidemia, coronary artery bypass grafting surgery in 2017, and a past smoking habit presented with chest pain of a 6-hour duration. The pain was oppressive in nature and accompanied by profuse sweating. The ECG during admission revealed an ST-segment elevation (STE) exclusively in aVL, accompanied by reciprocal ST-segment depression (STD) in III and aVF, V2, and V3 (Figure 1A). The medical team decided to transfer the patient to the emergency department (ED) for immediate serial ECGs and potential primary angioplasty in the catheterization laboratory within the door-to-balloon timeframe.