The leading cause of death in the United States is cardiovascular disease, regardless of gender. Women will more often have angina preceding their first myocardial infarct, but have more unrecognized infarctions than men. Women will be older, have more concomitant disease and present later in the course of their acute myocardial infarction. Although myocardial infarction may have similar clinical presentations in men and women, there are some important differences such as an increased incidence of non Q-wave myocardial infarctions in women, and the higher rate of complication and immortality from a myocardial infarct. Women develop less collateral cardiac vessels, which may explain the increased rate of hemodynamic complications after a myocardial infarct. Both early and late survival rates are also affected by the advanced mean age of women when they do present with a myocardial infarct. There is less data regarding treatment modalities based upon gender differences but in general, it appears that women benefit from established treatment modalities in the acute setting and subsequent to the event. It has been determined that there are epidemiologic differences, but pathophysiologic and clinical factors specific to women in this setting have yet to be determined.