Left-chest pain and infarct-like ECG changes occurred in a 47-year-old man who had had an orchiectomy for embryonic carcinoma of the testes and was receiving the second cycle of chemotherapy with vinblastine, bleomycin and cisplatin. Only creatine kinase was slightly elevated (90 U/l) among the heart-specific enzymes. Coronary angiography did not demonstrate any coronary abnormalities, but the ventriculogram showed apical akinesia. Chest pain and similar ECG changes again occurred during the third treatment cycle, this time without bleomycin. This sequence would suggest that vinblastine was the cause of the myocardial damage, although its pathogenesis is uncertain.