A 29-year-old female patient, complaining of squeezing retrosternal chest pain, was admitted to our emergency department. Her angina pectoris had started fifteen days ago and accentuated during the last two days. In her medical history, it was determined that during the last four years she had been admitted to hospitals with the same complaint twice, troponins were found to be elevated, she was hospitalized and coronary angiography (CAG) was totally normal. The young woman with recurrent acute coronary syndrome had a mutation in the MTHFR gene.