Combined infarction can be defined as the presence of ST segment elevation simultaneously in anterior and inferior leads. Their possible anatomical and physiopathological causes are suggested. Four cases of combined infarction, three of them in previously asymptomatic patients are presented, with their electrocardiographic and angiocoronarography patterns. Acute phase and 24 hours ECG ST changes are analysed and the possibility of an indirect approach to the angiographic diagnosis, is discussed.