A 72-year-old woman with diabetic chronic kidney disease visited the authors’ hospital with fever, dysuria, and left flank pain. She did not complain of typical angina upon her admission, however, given the presence of a new-onset left-bundle branch block, elevated cardiac enzymes, and documented E. coli septicemia, coronary angiography and percutaneous coro-nary interventions were performed for the mid-left anterior descending artery and the mid-to distal-right coronary artery. We should keep in mind that urosepsis in patients with diabetic chronic kidney disease, who are at high risk of cardiovascular disease, can be associated with painless acute myocardial Infarction.