Left bundle branch block with changing axis deviation also during acute myocardial infarction has been rarely reported. Changing axis deviation with changing bundle branch block during acute myocardial infarction has also been rarely reported. Prostate-specific antigen (PSA) is an established tool in detecting prostate cancer. Immediately after 15 min of exercise on a bicycle ergometer, serum PSA concentrations increased by as much as threefold. Apparently spurious result has been reported in a work about mean serum PSA concentration during acute myocardial infarction with mean serum PSA concentration significantly lower on day 2 than either day 1 or day 3 and it has been reported that these preliminary results could reflect several factors, such as antiinfarctual treatment, reduced physical activity or an acute-phase response. We present a case of changing axis deviation and elevation of serum PSA concentration in a 92-year-old Italian man with acute myocardial infarction. Our report confirms previous findings and extends the evaluation of PSA during acute myocardial infarction.