Case presentation A male patient, 75 years old, received esophageal carcinoma surgery in Oct 2005. On the second day after operation, the symptoms of dyspnea, chest discomfort and sweating took place when he was on bedside ordinary activities. ECG showed that: ST segment was elevated and T wave was depressed in leads V1-6, Biochemical markers of myocardial necrosis were elevated. Diagnosis: