A sixty-five-year-old male patient was admitted to a peripheral hospital with chest pain of several hours’ duration. This followed a previous episode, which occurred three days earlier. At admittance, the patient was in hemodynamic compromise, blood pressure of 90/55 mmHg, cold extremities and sweating. The ECG showed signs of infero-posterolateral acute myocardial infarction (AMI), confirmed by high blood troponin levels. The echocardiography showed pericardial effusion, with blood and clots in the pericardium.