A 60-year-old woman presented with repolarization disorders on the electrocardiogram after a generalized seizure, which immediately disappeared after vomiting up a 20-eurocent coin. We did not find any evidence of coronary artery disease. Multislice computed tomography demonstrated no coronary atherosclerotic stenosis but a close relationship of the esophagus with the coronary arteries. This relation was further studied in detail in a human cadaver. From our findings, it is most likely that the electrocardiogram alterations were due to compression of the ramus descendens posterior of the right coronary artery and/or the ramus circumflexus of the left coronary artery by the coin.