Urgent intervention. "time is muscle" is the mantra. Given a true mi, getting to a facility that can diagnose & manage an acute mi is critical. Initial anti platelet/anticoagulant therapy, followed by restoring blood flow by angioplasty ± stent placement, & then compliance with a "cardiac cocktail" of anti-platelet, lipid lowering, beta-blocker, & possibly ace inhibitor rx . Then risk factor control & no smoking!