Acute myocardial infarction is unusual in a young woman, especially with normal coronary arteriography. There are several mechanisms hypothesized, including coronary artery embolism, coronary spasm, illegal drug abuse and toxic condition. However, the etiology could be detected in only one third of these patients. Although air travel is known to precipitate deep vein thrombosis and pulmonary embolism, it is unclear whether it also causes myocardial infarction. We report a 37 year-old woman who had no risk factor for coronary artery disease, who suffered from acute myocardial infarction complicated with ventricular fibrillation after a long-distance flight across the Pacific Ocean from the United States to Taiwan. The coronary arteriogram disclosed patent coronary artery with slight intraluminal haziness in the proximal left anterior descending artery. The left ventriculogram demonstrated akinesia of anterolateral and apical segments with apical thrombus formation. We reviewed the related literature and considered the myocardial infarction in this patient was related to coronary thrombus formation after long-distance air travel.