This article review the biological and clinical importance of 2 potential outcomes of myocardial ischemia: the stunned and the hibernated myocardium. As for the stunned myocardium it is considered the possibility that either or oxygen free radicals, energy deficient or calcium overload are involved. As for the hibernated myocardium an hypothesis linked to the effects of intracellular acidosis and residual coronary flow on the metabolism of the myocyte is proposed.