Over the past decade major advances have been made in the understanding of myocardial infarction largely through the use of animal models of ischaemia and infarction. Ultrastructural and biochemical aspects of reversible versus irreversible ischaemic injury have helped to clarify the nature of ischaemic cell death. The presence of a border zone of cells which are in the reversible phase of myocardial injury following coronary artery occlusion allows for salvage of ischaemic myocardium by a number of interventions. These interventions include reperfusion, a variety of pharmacological agents, and physical and haemodynamic interventions. Several clinical studies have shown that these interventions may be beneficial in the treatment of patients with acute myocardial infarction.