Our understanding of the causes, diagnosis, and treatment of acute myocardial infarction (AMI) has evolved significantly over the last 40 years. This article, together with {1}, helpfully summarizes a universal definition of AMI that has been available to help the clinician with its diagnosis over the last 10 years. This definition states that there must be a rise and/or fall in a blood test sensitive to heart muscle damage (troponin I or T) with at least one value above the 99th percentile of the upper reference limit along with clinical evidence for a diagnosis of AMI. This clinical evidence includes symptoms of ischemia, which include either electrocardiographic evidence indicative of ischemia such as ST segment changes or new left bundle branch block, development of pathological Q waves on electrocardiogram, and/or new wall motion abnormalities on cardiac testing. This Recommendation is of an article referenced in an F1000 Faculty Review also written by Moussa Saleh and John A Ambrose.