The last 120 years have witnessed famous physicians and pathologists connected their medical investigation to study pathophysiology, diagnostics and treatment of acute myocardial infarction (AMI). Modern treatment algorithms based on precise and refi ned new technologies have as a main target to achieve rapid reperfusion and salvage threatened myocardium in order to enhance patients’ recovery and also to decrease mortality rate. Although long-lasting and multiple studies appeared to have impressive results, there still exist unknown or disputable viewpoints/concepts concerning for example the appearance of the reperfusion injuries, left ventricular remodeling, AMI in patients with normal coronary arteries, identifi cation of vulnerable lesions or plaques which are threatened by rupture or fi ssuring. This short historical review is aimed to remind us the evolution of the AMI knowledge and also to pull out some of the forgotten but relevant milestone hypothesis, as well as to help shaping the modern management of AMI.