A 41-year-old woman had acute respiratory failure related to a myocardial infarction. Attempts at orotracheal intubation were unsuccessful; therefore, an emergency percutaneous tracheostomy was performed. The patient was then taken to the cardiac catheterization laboratory for myocardial revascularization. After the tracheostomy cannula was removed, the patient recovered successfully and was discharged from the hospital. The percutaneous tracheostomy technique may be useful in similar patients who need emergency airway access.