A 84-year-old man presented to the emergency department complaining of chest 
pain and palpitations. He had no history of coronary artery disease. The 12-lead 
electrocardiography showed bidirectional ventricular tachycardia (BVT). Coronary 
angiography revealed severe mid left anterior descending and mid left circumflex 
lesions. The BVT, in this case, was most likely due to myocardial ischema. The 
ethiology of published BVT cases are most commonly digitalis toxicity and rarely 
herbal aconitine poisoning, hypokalemic periodic paralysis, cathecolaminergic 
VT, myocarditis, and Anderson-Tawil syndrome. The patient had neither of these 
underlying conditions. To the best of our knowledge and research in the 
literature, there was no report of bidirectional VT in the patients with 
myocardial infarction.