Overview: a 57-year-old lady developed chest pain and anterior St elevation whilst on the ward awaiting investigations for /cauda equina syndrome. She was transferred to the cath lab as an emergency. Her coronary angiography demonstrated occluded LAD in the mid vessel suggestive of SCAD. We predilated the lesion but the flow in the vessel was lost after balloon dilatation. We then used cutting balloon which restored TIMI 2 flow in the vessel. At this point her chest pain settled and ECGs resolved. We decided to stop and moved her to the ward.