Recently, a low-profile web drama, “Twelve Hours in Chang’an”, has become the focus of online buzz. This well-produced web drama reflects the story that took place in Chang’an City during the Sheng Tang Dynasty. The main characters of the drama, Li Bi, who is dedicated to the country, and Zhang Xiaojing, who is both good and evil, fight with the western wolf guards to protect the safety of the people in Chang’an, and finally achieve a tragic victory. The whole story takes place in twelve hours (24 hours), the plot is tight, every minute is the key to success or failure. This plot is particularly similar to the acute myocardial infarction in human body: “Time is heart muscle, time is life”, every second determines the life and death of a person. Today, we will talk to you about what happens to the human body within 24 hours of an acute myocardial infarction, and what “thrilling” things happen. Acute myocardial infarction (today simply referred to as ST-segment elevation infarction) is a severe and persistent ischemia of the corresponding myocardium caused by a dramatic reduction or interruption of the coronary blood supply, resulting in myocardial necrosis. It is a malignant heart disease with a very high mortality rate. The causes of coronary blood interruption are generally atherosclerotic plaque rupture arterial embolism, coronary spasm, etc. Once the blood supply is interrupted for more than 30 minutes, acute myocardial infarction can occur. Coronary artery occlusion begins 30 minutes after the myocardial cells begin to necrotize, and most of the myocardium coagulates necrosis after 1-2 hours. Over time, the area of necrotic myocardium gradually increases, and a portion of ischemic cardiomyocytes, if the blood supply is not restored in time, can trigger cardiomyocyte death. Cardiomyocytes are non-renewable cells; one cell dead is one less cell. Patients with heart attack will experience severe chest pain that persists without relief, accompanied by irritability and a sense of near death. Some patients also have severe arrhythmias, and death occurs before they even have a chance to come to the hospital. The diagnosis of acute myocardial infarction generally relies on clinical manifestations, electrocardiogram, and laboratory tests. The ECG is the most convenient and quickest test and must be done within 10 minutes after the visit. We do see many patients who refuse to have an ECG and later regret it. Laboratory tests are a definitive means of confirming the diagnosis, so do not refuse to have your blood drawn for laboratory tests either. Patients who have severe chest pain that does not go away, and who refuse to be examined after coming to the hospital, may be “self-destructive”. If you have severe chest pain that does not resolve for more than 30 hours, you should not insist on it by yourself, but call “120” immediately and send it to the nearest hospital, and it is not recommended to use your own vehicle to transfer it because you do not have the ability and equipment to resuscitate. Once the diagnosis of acute ST-segment elevation myocardial infarction is confirmed, reperfusion therapy should be performed within 3 hours of the onset of the disease, which means opening the blood vessels with drugs or interventional methods to restore the coronary blood supply. Reperfusion therapy includes “thrombolytic” therapy and emergency intervention (balloon dilation and stenting). The earlier the vessel is opened, the less myocardial necrosis and the lower the impairment of cardiac function, and the better the prognosis. Also acute mechanical complications due to infarction will be reduced and mortality can be greatly reduced. At present, thrombolysis can be relaxed to within 12 hours (in some cases within 24 hours), and in emergency interventional units to after 24 hours (the doctor’s judgment is needed). Our advice to you include: 1. Come to the hospital immediately if you have severe chest pain for 30 minutes, do not observe by yourself and delay the time. 2.After coming to the hospital, listen to the doctor’s advice and complete the ECG examination and blood test at the first time, do not refuse the above examination. 3.Once the acute myocardial infarction is confirmed, you must choose the treatment plan of “reperfusion”. 4.Trust your doctor, who has seen too many patients who died suddenly because of aversion, we have much more experience than you. 5.Don’t ask around the so-called neighbors, relatives, friends, patients, or even outside doctors (cardiology and non-cardiology), even if they have relatively professional medical knowledge, but they don’t understand your immediate situation, they will not be responsible for their “inappropriate” ideas, the only person responsible for you is the doctor in front of you. 6. Do not withhold medical history because every piece of information may be very important.