This document provides guidance on the early management of suspected myocardial infarction (MI). It outlines key risk factors, clinical presentations, diagnostic steps including EKG and imaging, and treatment recommendations including aspirin, nitrates, anticoagulation, reperfusion therapies, beta blockers, ACE inhibitors, and antiplatelet medications. Treatment should begin promptly based on history and risk rather than waiting for test results, with a goal of reducing mortality from MI.

1. Early Management of Suspected Myocardial Infarction DR Ihab Suliman MBBS(KHAR),ECFMG(USA)MRCP(UK), Board Certified nuclear cardiology(USA) Associate Consultant Adult Cardiology National Guard Hospital Member of the European Atherosclerosis Society. Member of the European Society of Cardiology. Member of the European working group on Nuclear Cardiology& Cardiac CT. Member of the European Association on Heart failure. Member of the American Society of Cardiovascular CT Member of the American Society of nuclear cardiology

3. 19 years old female,single ,pharmacy student came with chest pain ,LDL 2.0(Never ignore chest pain)

4. 19 years old female,single ,pharmacy student came with chest pain ,LDL 2.0,ECG done on discharge.

10. A 26 year old woman presented 1 week post delivery of her first baby. She has sharp L sided chest pain and she is short of breath.

16. 26 yr old thin man with sudden onset of severe R sided sharp chest pain ,tachypnoeic.

31. 50 years old female with chronic renal failure,chest pain & dizziness she is hypertensive on lisinopril

32. 26 Old army officer had flu last week,felt chest pain while driving his car,pain increased by deep breath,he has no history of DM or HTN,nonsmoker,lipid profile LDL 2.0 MMMOL/ L