Introduction: Acute myocardial infarction (AMI) is an important cause of admission in the intensive care unit in hospitals. AMI ranks very high in the differential diagnosis of acute chest pain because prompt diagnosis and early treatment can save a life, preserve left ventricular function, reduce complications and can also impact the quality of life. Aim: Current study was done to evaluate the diagnostic accuracy of clinical history for detecting acute myocardial infarction compared to the reference standard. Result: Our final dataset comprises of 450 patients (279 [62%] men, 171 [38%] women) ages 20 to 90 years. The prevalence of acute myocardial infarction was 41% (187 of 460, 95% CI 37% to 46%). Of the 450 patients, 47 (10%) died during the hospital stay. Those who died were significantly older than those who survived (63.4 vs. 57.01 years). Patients with AMI were more likely to die (26%; 38 of 147) compared to those without MI (9 of 263; 3%). Conclusion: Of the 187 patients with acute AMI, 145 (78%) were assigned a discharge diagnosis of ST elevated myocardial infarction (STEMI) and 42 (22%) were assigned a diagnosis of non-ST elevated myocardial infarction. A total of 34 of 145 (23%) patients with STEMI died, compared to 4 of 42(10%) patients with non-STEMI. Even in a high prevalence setting, no sign or symptom exhibited by patients presenting with possible acute MI proved effective enough alone to rule in or out Acute Myocardial Infection (AMI).