A case of a 53-year-old male with acute myocardial infarction complicated by cardiac arrest is presented. Due to neurological complications which were transient, the patient was not selected for primary angioplasty. Three days later his condition significantly improved and the patient was transferred to internal ward were he developed cardiogenic shock due to a massive pulmonary embolism. Thrombolysis and low molecular weight heparin were effective and the patient did well during subsequent hospitalisation period. Coronary angiography was performed 4 weeks from hospital admission and revealed a total left main coronary occlusion with good collateral circulation from the right coronary artery. Finally, the patient underwent successful CABG.