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Myocardial infarction (MI) describes the process of myocardial cell death caused by ischemia or the imbalance between myocardial oxygen supply via the coronary arteries and demand. In the United States each year, an estimated 1.1 million people experience an acute MI or die from coronary heart disease. 1 In 2016, it was estimated that approximately every 34 seconds one American would have a coronary event and about every 1 minute 24 seconds an individual would die from a coronary event. 1 According to the most recent World Health Organization report in 2015, coronary heart disease remains the leading cause of death worldwide. Hence the early recognition and diagnosis of acute MI is vital for the institution of therapy to limit myocardial damage, preserve cardiac function, and reduce mortality. Acute coronary syndrome (ACS) refers to the constellation of clinical signs and symptoms caused by worsening myocardial ischemia. In the absence of myocardial damage, assessed by measuring cardiac biomarker levels, patients can be classified as having unstable angina. When myocardial damage is present, patients with ACS can be grouped into two major categories of acute MI:(1) patients with new ST segment elevation on the electrocardiogram (ECG) that is diagnostic of acute ST segment elevation myocardial infarction (STEMI), and (2) patients with non–ST segment elevation myocardial infarction (NSTEMI) who have elevated cardiac biomarkers in an appropriate clinical setting, with or without ischemic ECG changes. 2 Clinical trials have established the benefit of early reperfusion therapy in patients with STEMI and an early invasive …