From early middle age onwards myocardial infarction is recognised as being a major cause of death and disability in this country. Approximately 300,000 people in the UK experience an MI each year and about 140,000 will die as a result. The rapid management of patients with chest pain should ensure that there is no more than 30 minutes delay in decision-making and initiation of thrombolytic therapy. This 'door-to-needle' time should be reduced to 20 minutes from April 2003 in line with national service framework recommendations. This article provides an overview of the signs, symptoms and diagnosis of this acute condition. The contemporary management/treatment advocated in the NSF is presented and nursing interventions are explored briefly.