Improvements in the management of acute myocardial infarction together with population ageing have contributed to a growing burden of heart failure. Around half of new cases of heart failure in patients aged less than 75 years are due to coronary artery disease; many of these patients develop heart failure in the context of acute myocardial infarction. Left ventricular systolic dysfunction is the single most common cause of heart failure after myocardial infarction. Of the estimated 65,000 new cases of heart failure in the UK each year, it is likely that around 15,000 occur in the context of acute myocardial infarction. Ventricular remodelling generally occurs in the early period after myocardial infarction, and early identification offers the potential to modify this process and reduce the risk of heart failure. Clear guidelines should be built into the myocardial infarction care pathway to ensure an integrated approach from hospital and community services.