Coronary involvement of polyarteritis nodosa (PAN) has been mostly identified in postmortem studies. We report a case with inferior myocardial infarction (MI) because of coronary dissection and thrombosis in PAN. A 23-year-old woman with chest pain was admitted to the emergency department. The admission ECG was suggestive of inferior MI with no right ventricular infarction. Coronary angiography revealed an occluded right coronary artery because of coronary dissection and concomitant thrombosis. Coronary angioplasty and stent implantation were performed successfully without complications. This report emphasizes the importance of PAN in spontaneous coronary dissection and thrombosis even in young patients.