Wolff-Parkinson-White (WPW) syndrome is an electrical conduction abnormality of the heart in which atrial impulses are transmitted to the ventricle through an accessory pathway, leading to supraventricular tachycardia [1]. On EKG, WPW presents with shortened PR interval, widened QRS, and a characteristic delta wave. Here, we present the case of 44-year-old African American male with a history of preexcitation/WPW pattern and no known history of coronary artery disease who came to the hospital complaining of atypical chest pain. He had transient ST elevation in beats with delta waves, both in the ambulance and emergency room EKGs (Figure 1 and 2) . Five minutes later, a repeat EKG showed ST elevation along with PR depression mimicking pericarditis (Figure 4) . Cardiac enzymes remained normal. EKG stress test with myocardial perfusion imaging was negative for ischemia and echocardiogram was normal.