Myocardial infarction with non-obstructive coronary arteries (MINOCA) defines a group of heterogeneous clinical settings which satisfy the criteria for acute myocardial infarction (AMI) diagnosis in the absence of angiographic evidence of ≥50% diameter stenosis in any major epicardial vessel [1]. Plaque disruption, coronary thromboembolism, coronary artery spasm, coronary microvascular dysfunction, and spontaneous coronary artery dissection are mentioned among the most common causes of MINOCA; nevertheless, in up to 25% of patients the etiology remains unknown [2]. Because of the heterogeneous etiology and pathogenesis, there is no standard treatment protocol for the management of MINOCA. A case-by-case comprehensive analysis of the potential causes, even the rarest, is thus of paramount relevance for both prognostic and therapeutic purposes. Cardiac papillary fibroelastomas (CPFs) are rare benign primary cardiac tumors (PCTs) which in most cases involve the aortic valve. CPFs can be asymptomatic and therefore, the diagnosis can be incidental. Nevertheless, harmful embolic complications of CPFs have been described [3]. We report the case of a young patient presenting with MINOCA very likely caused by a CPF of the aortic valve.