BACKGROUND Myocardial Infarction (MI) is the term used to describe a state of myocardial necrosis secondary to an acute interruption of the coronary blood supply. 1 It is one of the manifestations of coronary heart disease leading to morbidity and mortality. 2 World Health Organization (WHO) has declared cardiovascular disease as a modern epidemic. 3 Most of the myocardial infarctions results due to disruption in the vascular endothelium associated with atherosclerotic plaque, which in turn stimulates the formation of an intracoronary thrombus, which further leads to occlusion of coronary artery blood flow, if this occlusion persists for more than 20 minutes can results in irreversible myocardial cell damage and even cell death. Severity of the condition is dependent on three factors-the level of occlusion, length of time of occlusion and presence or absence of collateral circulation. Rupturing of the plaque causes complete coronary occlusion, which usually results in STEMI. This arises most often from a plaque that previously caused less than 50% lumen occlusion. 4 Clinical diagnosis as well as diagnostic classification is commonly based on electrocardiographic findings to differentiate between the two types of MI. There are mainly two types, STEMI and NSTEMI. Complications of acute MI are many, which in turn leads to high incidences of mortality, but among all arrhythmias, cardiogenic shock and heart failure are found to be commonly associated with it along with electrolyte disturbances. The aim of the study is to observe the prevalence of various electrolyte (Na, K, CL and Mg) imbalances along with complication of cardiogenic shock, arrhythmias and heart failure in the patients of acute myocardial infarction. MATERIALS AND METHODS This is a prospective study in which the 100 patient admitted with signs and symptoms of acute myocardial infarction diagnosed clinically both males and females were selected over 1 year. Patients presented with symptoms of AMI within 48 hours of onset with history of chest discomfort, ECG changes of acute myocardial infarction and rise of cardiac enzymes.