Anthracosis of lung is characterized by black discoloration of the bronchial mucosa that can obstruct the bronchial lumen and is associated with bronchial anthracofibrosis (BAF). This disease usually presents with a chronic course of dyspnea and cough in elderly nonsmokers. The most commonly postulated cause of anthracosis is prolonged exposure to dust and wood smoke, and the prevalence in the general population has been roughly estimated because the exact diagnosis requires bronchoscopy, which is impossible for the general population due to ethical considerations. In this case, a 57-year-old male patient was presented with chest pain radiating to the left arm. The patient had a history of working in a car spare parts warehouse and a side job in mining, with a smoking history of one pack a day for more than 30 years. The diagnosis of heart failure and anthracosis was carried out based on echocardiography and medical thoracoscopy.