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Cardiac adverse events, while infrequent, are the primary complications to electroconvulsive therapy (ECT). Acute myocardial infarction is a rare complication of ECT. Here, we report a case of a 49-year-old male with no known cardiac history and with intermediate cardiac risk who developed an Anterolateral ST elevated myocardial infarction after a course of ECT. His risk factors for coronary artery disease included hyperlipidemia and tobacco dependence. Coronary angiography demonstrated a complete occlusion of the proximal left anterior descending artery. The hemodynamic changes during ECT will also be discussed, which contribute to the associated cardiac complications.