[Treatment of acute myocardial infarction in 2007]

The two immediate priorities when faced with acute myocardial infarction are 1) to be able to deliver electric cardioversion in case of need and 2) to rapidly start reperfusion therapy (angioplasty or thrombolysis). During the hospital phase, antiplatelet agents are given to all, betablockers should be used if there is no heart failure, and ACE-inhibitors are mostly indicated for patients with poor hemodynamics. At discharge, in addition to instructions regarding not smoking, a balanced diet, and regular physical exercise, a statin and antiplatelet therapy remain a long-term indication for all. ACE inhibitors should be continued in case of high blood pressure, heart failure or a left ventricular ejection fraction < 40%. The main benefit of betablockers is for patients with residual angina and/or chronic heart failure.