Terbutaline sulfate was administered i.v. and orally to an 18 yr old woman because of premature labor. This therapy resulted in retrosternal chest pain associated with major ST segment depression on the ECG. Sublingual nitroglycerin abated the chest pain and produced resolution of the previously noted ST segment depression. Pharmacologic effects of terbutaline in concert with the stress imposed by pregnancy may provide a hemodynamic setting conducive to a disturbance in the myocardial O2 supply and demand relationship.