The details of 60 patients scheduled for emergency coronary artery surgery are presented. Forty-two patients were categorized as having "impending" infarctions and 18 were operated on within 4 hours of sustaining acute myocardial infarctions. The patients presented with different haemodynamic disturbances and the selection of anaesthetic drugs was modified accordingly. We have found that conventional anaesthetic methods, conservatively applied, can be used safely in this group. The induction of anaesthesia and the increase in arterial oxygen tensions obtained by controlled ventilation produced an improvement in e.c.g. signs of ischaemia, and also reduced myocardial irritability. Circulatory complications were treated according to information obtained from simple monitoring techniques. The responsibility of the anaesthetist in postoperative care is emphasized and a regime of postoperative ventilatory management is described.