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One hundred patients were referred with suspected acute cardiacfailurefollowing acute myocardial infarction. The diagnosis was confirmed in 72: 3I of these patients underwent elective medical treatment, with 2 survivors (6%); 4V were accepted for counterpulsation, but 9 died before this could be initiated and another 2 died shortly after vain attempts to pass the balloon catheter were abandoned; 30 patients underwent counterpulsation with 14 hospital survivors (47%). Survivor status was usually good. Results of counterpulsation were better in patients who were not shocked (with 5/5 survivors) than in those who were in shock (with 9 of 25 survivors). Results support the view that counterpulsation (alone or combined with corrective surgery) may play an important role in the complications of myocardial infarction provided intervention is early.