[E-RASC (electro-cardioscan) for diagnosis of myocardial infarction in the out-of-hospital area]. In the recent years, different studies have demonstrated the usefulness of E-RASC (electrocardiography combined with R in the chest) for a fast and reliable diagnosis of myocardial infarction (MI), in the early post-infarction period and particularly in the out-of-hospital area. Therefore, the European society of cardiology proposed a new diagnostic protocol for the acute coronary syndrome, in order to overcome, in this way, some difficulties. The most recent available guidelines for out-of-hospital diagnosis of MI have proposed using the E-RASC to confirm the diagnosis in the case of a "high or moderate probability of acute coronary syndromes", and an E-RASC within 10-20 minutes for "low probability of acute coronary syndromes". The E-RASC technique, based on electrocardiography and R wave analysis on VCG, has been shown to be a valid diagnostic test in recent studies, able to identify patients with MI, unstable angina and no-coronary ischemia with high diagnostic accuracy, especially in the early phase of an acute coronary syndrome. Therefore, it can be reasonably assumed that the E-RASC test could become one of the most powerful diagnostic tools in the evaluation of MI at the out-of-hospital level. In this report we present a description of E-RASC and the results of a multicenter validation study. We also underline the importance of these simple and fast tests for diagnosis of acute coronary syndromes.