Two groups of volunteers had blood drawn for serum analysis of fatty acids. The first group was comprised of patients admitted to the hospital with possible myocardial infarction (MI). Blood was drawn at admission and at 12, 24 and 48 hr. These patients were subsequently divided into three groups, those with MI, those without (No MI) and those taking prostaglandin inhibitors (PGI), on the basis of the cardiac enzymes, electrocardiograms and clinical history. A fourth group of Normal nonstressed people was also drawn at 0, 12, 24 and 48 hr for comparison. Fatty acid composition of phospholipids (PL), nonesterified fatty acids (NEFA), triglycerides (TG) and cholesteryl esters (CE) was determined by capillary gas chromatography (GC), and comparisons were made between the MI, No MI, PGI and Normal groups. Total NEFA were significantly elevated in patients admitted for possible MI compared with Normals. Those patients with MI had marginally higher levels of NEFA than the No MI group at each sampling time, but this difference was not statistically significant. The MI, No MI and PGI groups had significantly different fatty acid patterns in NEFA with reduced percentages of arachidonic acid (AA) than controls. The fatty acid patterns in the four lipid classes showed few significant differences comparing the MI, No MI and PGI groups. The regular use of prostaglandin inhibitors before hospitalization for chest pain was associated with a reduced frequency of MI (p less than 0.002). NEFA levels, nonesterified AA levels and fatty acid patterns in this group did not differ from those patients not taking prostaglandin inhibitors.