Although acute myocardial infarction (AMI) is a common disorder that makes people seek emergency healthcare, there is little evidence on the diagnostic accuracy of symptoms and signs, for the diagnosis of acute myocardial infarction. Aims: Current study was done to evaluate the diagnostic accuracy of physical examination __ampersandsignamp; electrocardiogram for detecting acute myocardial infarction compared to the reference standard. Material: Of the 481 patients enrolled, we evaluated 450 patients, 279 (62%) men and 171 women (38%); aged 20 years to 90 years. The patients with acute myocardial infarction were aged almost similar to those without infarction (58.6 vs. 57.1 years). Results: The prevalence of acute myocardial infarction was 41% (187 of 450). 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. Conclusion: Our study concluded that no single sign or symptom or a laboratory diagnostic method with possible acute MI proved effective enough alone to rule in or out AMI.