Abstract :Atrioventricular nodal reentry tachycardia (AVNRT) represents one of the most common arrhythmias in emergency cardiology. It can occur in patients of all age groups and may occur in presence or absence of heart disease including coronary artery disease. During the periods of AVNRT, it is not uncommon to see ST segment depression and T wave changes. These, generally, persist transiently in the post conversion period and do not represent ischemia. We present a unique case report of ST segment elevation in the Left anterior descending artery (LAD) territory with T wave inversion during AVNRT. Coved ST segment and T wave inversion persisted till the patient was discharged from the hospital. CT angiography of coronaries done revealed 99% block of obtuse marginal (OM) after its origin.