Coronary heart disease remains the leading cause of death for men and women in the United States and other industrialized nations. Acute myocardial infarction accounts for a majority of these deaths, approaching 750,000 yearly. Thrombolytic therapy has revolutionized the treatment of myocardial infarction, saving lives to a greater extent than any treatment developed to date. The identification of patients best suited for thrombolytic therapy has been a challenging task, as has the ideal adjuvant strategy. Further, the noninvasic diagnosis of treatment successes and failures, as well as the expeditious triaging of patients requiring mechanical/surgical revascularization have been difficult to define, but progress has been made recently. The emergence of information vital for patient care has appeared at an extraordinary pace, with hundreds of articles being published yearly. This text is designed to bring the medical and scientific communities up to date. It should serve as a foundation for future investigation, as well as a resource.