a-e) This 72-yr old gentleman with known CAD and previous NSTEMI was thrombolysed for an anterior STEMI (peak CK 1850). MRA (a) showed mid LAD and ostial LCX stenosis with corresponding enhancement in CE-MRI (b). Fusion (c) of MRA (a) and CE-MRI (b) revealed marginal branch as culprit lesion (arrow). LE images showed transmural scar of the lateral wall. XRA of the left system showed ostial LCX and mid LAD stenosis. XRA of the RCA confirmed CE-MRI findings with retrograde filling of the completed occluded marginal branch (e, arrows). f-g) This 48-yr old man was admitted with troponin positive ACS (1st presentation) with no siginificant ECG changes. Fusion (h) of MRA (g) and CE-MRI demonstrate mid RCA stenosis as culprit lesion (arrow). LE images showed no scar. XRA (j) showed proximal to distal tight RCA stenosis with normal flow (culprit lesion, arrow).