We have come a long way from the time when a heart attack was a death sentence or at least the end of a normal life. Dwight Eisenhower had one when he was contemplating running for reelection for president in the 1950s. Treatment then was morphine, an oxygen tent, and weeks of bed rest. There was a general understanding that he should retire and not seek reelection. Others including Paul Dudley White advised rehabilitation and resumption of his job. Eventually we learned that a thrombus causing the heart attack could be dissolved, and if blood flow was restored quickly enough, the heart attack could be stopped. Balloon catheters made that maneuver more efficient, quicker, and more reliable. Primary percutaneous coronary intervention (PCI) has become the life saving and myocardium saving major contribution of interventional cardiology. That has been true for a long time and has resulted in a revolution of emergency medicine, from the proliferation of cath labs to the reorganization of emergency medical services. Today, primary PCI is a Class I guideline recommendation for heart attacks, and the focus is on doing it quickly. That goal persists, but we love to iterate and try to improve on what we do, so the question about what to do with other obstructed arteries not involved in the heart attack has been pondered in a number of ways. Observations suggested that leaving those other lesions alone might be best while concentrating on the culprit lesion that caused the attack. Subsequently, that has been challenged because other lesions might progress or close, so why not open them as well? The most compelling of randomized trials on the subject was the COMPLETE trial, which showed that it was safe and perhaps better to open non-culprit arteries, especially if done in a separate session after the infarct had been stopped by the primary PCI [ ].