CASE PRESENTATION: A 38-year-old female with a history of polycystic ovarian syndrome (PCOS), diabetes mellitus, hypertension and hypothyroidism was admitted to hospital for chest pain. Her medical records demonstrated evidence of PCOS and hyperandrogenism; a pelvic ultrasound with multiple ovarian cysts and low serum sex-hormone binding globulin and elevated free and total testosterone levels. Her chest pain began at rest, on the left side of her chest, non-radiating. On examination, she was noted be morbidly obese, with the presence of facial hair, acanthosis nigricans, and chest hair. EKG showed a normal sinus rhythm with prolonged QT (492ms) and labs showed elevated Troponin peaking at 12.16mcg/dL. She was treated with aspirin, intravenous heparin, clopidogrel and nitroglycerin with resolution of her chest pain. She underwent left heart catheterization with evidence of single-vessel CAD (second obtuse marginal and first left postero-lateral) and SCAD of the second obtuse marginal artery. Since she had no further symptoms and no further ST-segment changes, she was medically managed, and directed to follow-up with endocrinology for hyperandrogenism.