BACKGROUND: Despite overall declining death rates from cardiovascular disease, the number of women dying of cardiovascular disease increases each year, with substantially higher rates in African American women than in white women. OBJECTIVE: To investigate differences in presentation, diagnostic method, and type of infarction between African American and white women with myocardial infarction. METHODS: Chart review of all women with discharge diagnosis of myocardial infarction. RESULTS: No significant differences were found between African American and white women in admitting diagnosis, diagnostic methods, or type of infarction. At the time of admission, 2 medical history variables, stroke and hypertension, differed significantly between African American and white women (P = .027 and P = .002, respectively). CONCLUSIONS: Healthcare professionals must be aware of possible racial differences in medical history, signs and symptoms, and prognosis when assessing patients and planning interventions. Studies with larger samples are needed to confirm these findings on African American and white women with myocardial infarction.