Myocarditis is an inflammatory heart muscle disease, resulting from various etiologies. The clinical presentation of myocarditis is variable and often mimics myocardial infarction. The diagnosis of acute myocarditis is frequently empiric, and is made on the basis of the clinical presentation, electrocardiographic, ecocardiography changes, elevated cardiac enzymes, and lack of epicardial coronary artery disease. Although history, physical examination, laboratory data points, and electrocardiogram (ECG) are helpful, distinguishing among pericarditis, myopericarditis, and myocardial infarction can be difficult. This case report illustrates some of the difficulties in differentiating between myopericarditis and myocardial infarction in a 16-yearold patient presenting with chest pain and ECG showed infero-lateral ST-segment elevation.