In this special edition of JACC, Dr. Valentin Fuster offers an in-depth summary of the 2025 ACC/AHA guidelines on acute coronary syndromes, highlighting expert perspectives and landmark updates. The episode explores key topics including high-sensitivity troponins, antithrombotic strategies, and a global push toward harmonized cardiovascular care guidelines. With historical context and forward-looking commentary, it’s an essential listen for clinicians navigating the evolving landscape of acute cardiac care.