Myocardial reperfusion therapy has revolutionized the management of patients with acute myocardial infarction (AMI), reducing its mortality in as much as 50%. However, due to reasons that vary from region to region, several eligible patients do not receive such treatment. A new strategy, "primary angioplasty after transfer to an intervention center", proved to be promising and to have a great potential, because more patients will be able to benefit from the most efficient form of reperfusion therapy. A new chest pain protocol to be adopted at hospitals without a catheterization laboratory, but with a "program of transfer", has been suggested. In Brazil, some protocols have been established, but none in the public health system. Nevertheless, the Rio de Janeiro branch of the Brazilian Society of Cardiology (SBC/RJ) has developed a model based on new concepts, which, if implemented in major urban centers, can reduce the high mortality rates due to AMI in our country.