Myocardial infarction with ST elevation (STEMI), without ST elevation (NSTEMI) and unstable angina pectoris are parts of acute coronary syndromes (ACS). ACS represents an illness with serious prognosis. Both invasine diagnostic and interventional treatment are important tools of ACS management. Invasive diagnostic is needed after fibrinolysis for STEMI in order to exclude residual stenosis of the infarct related artery. Risk stratification is very important in NSTE ACS patients. Decision for urgent or early invasive strategy is than made depend on the risk score level. In NSTE ACS patient with low risk score a non invasive stress test for inducible ischaemia is recommended. In case of stress test positivity coronary angiography should be planned before discharge.