Acute myocardial infarction is the number one killer of men and women in the United States. Early recognition and treatment has been shown to decrease mortality and infarct size, and to improve left ventricular function. The home healthcare nurse is in a key position to perform a swift, pertinent assessment that can detect an acute myocardial infarction, provide the patient with the valuable information to decrease the time delay until thrombolytic therapy is initiated, participate in the rehabilitation post-myocardial infarction, and provide education and counseling for coronary heart disease risk reduction.