Is there any good reason to give intravenous nitroglycerin during evolving acute myocardial infarction? How about a beta blocker? Should an ACE inhibitor be started routinely within the first 24 hours of infarction? When is aspirin useful for suspected acute myocardial infarction? Is it safe in patients with contraindications to thrombolytic therapy? In this article, Dr Rapaport answers these and many more questions by summarizing findings of important studies and describing conclusions he has come to on the basis of his own clinical experience.