ST-elevation myocardial infarction is a common and important condition. Myocardial infarction is a leading cause of morbidity and mortality so it is vital that we get the diagnosis and management of this condition right. To find out more about this problem and what we can do about it, please do listen to his podcast interview with Mahi Ashwath, Professor of Medicine and Radiology and Inaugural Reuben Jacobs Chair in Internal Medicine at the UHS/UT Heart and Vascular Institute, San Antonio, Texas. Mahi is author of this topic on BMJ Best Practice. Competing interests: MA is a consultant for Tersera.