The authors present an article reviewing the fundamental importance of transthoracic echocardiography in the early phase of acute myocardial infarction (AMI). They refer to its significance in the diagnostics and differential diagnostics statements of AMI and its complications, evaluation of left ventricular systolic and diastolic function. The authors emphasize its possibilities in risk stratification and prognostic evaluation of the patients after AMI. Regarding the valuable possibilities of transthoracic echocardiography which in a decisive manner often determine the further diagnostic and therapeutic procedures, the authors postulate that this procedure should be performed in each patient with AMI already in early phase. They consider the inaccessibility of early bed-side transthoracic echocardiography as a management failure. (Fig. 2, Ref. 72.).