OBJECTIVE: One of the most serious and frequent consequences of acute myocardial infarction is heart failure, which has moved into the focus of public health care in the last few years. The presented modeling determines the epidemiological and health-economic disease burden of post-acute myocardial infarction heart failure in Germany. METHODS: Basis for the concept was a literature review of relevant publications since 1990. The incidence of post-acute myocardial infarction heart failure was estimated for two scenarios and, with the help of a Markov model, the course of the disease and the associated use of resources over a period of nine years was calculated. Subsequently, the annual cost of all prevalent cases was determined. RESULTS: The calculation of the incidence in Germany varies between 50,000 (best case scenario) and 90,000 (worst case scenario) per year. These patients cause total costs of 1.4 - 2.5 billion euro during the selected observation period (the portion of direct costs is approx. 55 %). The prevalence per year is estimated to be 250,000 to 450,000. Per year these patients cause a financial burden of approximately 0.9 - 1.6 billion Euros. The majority is due to hospital treatment (0.3 - 0.5 billion Euros) and the loss of productivity due to premature mortality (0.2 - 0.4 billion Euros). Apart from the rateable monetary strain, it has to be assumed that after the manifestation of heart failure the quality of life for these patients is reduced by about 50% compared to that of the normal population at a comparable age. CONCLUSION: In light of the heavy financial burden - in particular due to hospital treatment and loss of productivity - following the manifestation of heart failure, an early and effective therapy of the initial myocardial infarction is essential. If heart insufficiency nevertheless develops following myocardial infarction, optimum secondary preventive strategies are necessary.