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The patient with acute myocardial infarction must receive oxygen, Aspirin^® and analgesia with morphine as soon as possible. In most patients, gliceryl trinitrate is also indi­cated. The doctor should reassure the patient and give him/her a brief explanation of the illness. Upon arrival to the hospital, only the most impor­tant investigation should be done before mak­ing the decision about reperfusion therapy. Prompt reperfusion is the most effective treat­ment in acute myocardial infarction. In Slovenia, thrombolytic drugs, including streptokinase, tis­sue plasminogen activator and urokinase, are mostly used to achieve reperfusion. In some cen­ters, primary (direct) percutaneous translumi­nal coronary angioplasty has been introduced. During the acute phase of the disease, even a hemodynamically stable patient must rest in bed for the first 12 hours. After that time light physical activity can be started. During the peri­od of bed rest, the patient should be given heparin. All patients, except those with contraindica­tions, must be treated with a beta blocking drug and an ACE inhibitor. The course of Aspirin^® and beta blocking drugs should be continued indef­initely, while ACE inhibitors are discontinued after 4 to 6 weeks if there are no additional indi­cations. The authors also discuss unexpected and potentially lethal complications that may arise during the acute phase of myocardial infarction.