There is a frequent coexistence of biliary disease and arteriosclerotic heart disease. Occasionally the electrocardiographic changes are severe and might militate against surgical intervention. Three patients with biliary disease, gallstones, and profound T-wave inversion on the electrocardiogram were given 2 mg of atropine intramuscularly. Marked improvement in the ECG occurred after taking the atropine and the improvement was corroborated by cholecystectomy. Ten other patients with T-wave inversion and ischemic heart disease were also given atropine. In these patients without gallbladder disease, no change occurred.