<prompt> Answer this question truthfullyWhat causes ST elevation myocardial infarction?  <response>: <reason> There have been reports of a 4 fold rise in the risk of MI following a heavy meal. This rise in risk may account for a second peak in the circadian variation in the onset of MI around 8 P.M. in the evening. The mechanism underlying the association is not clear. It has been speculated that ingestion of a heavy fatty meal may be associated with a rise in prothrombotic factors and heart rate, and a reduction in vascular reactivity. 