Myocardial bridging causing systolic compression of epicardial coronary arteries may be an incidental finding at coronary arteriography. Bridging rarely causes myocardial ischaemia. A young man presented with chest pain and striking abnormalities of ventricular repolarisation that initially were treated as myocardial infarction. At cardiac catheterisation the coronary arteries were normal apart from the presence of a myocardial bridge affecting a major diagonal branch of the left anterior descending artery. Echocardiography was normal with no features of hypertrophic cardiomyopathy.