Case 1: a 45-year old man with no significant past medical history presented on a weekend to the emergency department of a referral hospital in capital city of Cameroon, Yaoundé at about 1 am in the morning, 1 hour after acute onset of substernal chest pain. The attending physician at the emergency made the diagnosis of acute gastritis and prescribed analgesics, omeprazole (a proton pump inhibitor) and anti-spasmodics and sent the patient home. Electrocardiography and testing for markers of myocardial injury were not performed. Two days later, he went to see his primary care physician who suspected a myocardial infarction and sent him to a cardiologist because he feared a more serious condition. Evaluation by the cardiologist revealed an acute myocardial infarction with persistent ST segment elevation, elevated markers of myocardial necrosis and segmental wall motion abnormalities on echocardiography. Evaluation for cardiovascular risk factors revealed dyslipidemia and physical inactivity.