Under normal conditions, blood flows in a closed-loop structure in the heart and blood vessels. If blood flows out of this closed-loop structure, it is called bleeding; if the flowing blood forms a solid clot in the above structure, it is called thrombus. Among pathological thrombosis in the heart, arteries, veins and microvessels, the most serious is acute myocardial infarction caused by thrombosis in the coronary arteries, which can lead to endless problems and even death if not treated promptly (including thrombolytic therapy). In the 1980s, due to the application and extensive development of angiography and angioscopy technology, it was established that intracoronary thrombosis is the cause of acute myocardial infarction, and when cardiac catheterization is performed within 4 hours of the onset of chest pain, about 90% of patients have complete occlusion of the artery associated with the infarcted myocardium, and evidence of intracoronary thrombosis can also be found; if given in a timely manner via the coronary artery or peripheral veins Thrombolytic drugs, if given promptly through the coronary arteries or peripheral veins, can open the occluded artery and thus reduce near-term mortality. It is well known that the establishment of the coronary care unit (CCU) in the 1960s reduced the mortality rate of acute myocardial infarction from 30% to 15%; before the use of thrombolytic therapy in the mid-1980s, the mortality rate remained between 13% and 15%, and the combination of thrombolytic therapy and aspirin reduced the mortality rate of patients with acute infarction to less than 8%. Thus, thrombolytic therapy and intracoronary angioplasty (PTCA) have been called two major breakthroughs in the history of coronary artery disease treatment in the 1980s and milestones in the history of the development of the cardiovascular field. It must be soberly recognized that time is life. Thrombolysis within 6 hours of onset can reduce the mortality rate by 30%; thrombolysis within 1 to 2 hours of onset can reduce the mortality rate by 50%. However, drug thrombolysis is not recommended in the following cases: 1. 12 hours after onset of disease, especially more than 24 hours. 2. Contraindications: cerebral hemorrhage or uncontrolled hemorrhage; intracranial lesions within 6 months; uncontrolled hypertension (blood pressure ≥ 180/110 mmHg); surgery or severe trauma within 10 days; active gastrointestinal bleeding, etc. 3. Thrombolytic therapy is also not recommended for unstable angina pectoris and non-Q-wave acute myocardial infarction. In the mid-1980s, it was concluded that the effectiveness of intravenous thrombolysis was comparable to that of intracoronary thrombolysis. Since then, there has been a focus on more widespread and rapid intravenous application of thrombolytic agents. However, less than half of patients with acute myocardial infarction benefit from pharmacologic thrombolysis, and the efficacy falls short of expectations. So, why is pharmacological thrombolysis not as successful as it should be? The reasons are complex, but there are three main reasons: 1. The time from the onset to the start of thrombolysis is the most important. Due to the lack of medical knowledge of patients, when the onset of chest pain, a piece of nitroglycerin is taken under the tongue every 5 minutes, and after 2 to 3 times of invalidation, they still do not realize the possibility of acute myocardial infarction and take unfavorable measures, such as not going to the hospital quickly but taking “thrombolytic” drugs, so that when the patient is sent to the hospital with the ability and condition of intravenous thrombolysis, the opportunity is lost. By the time the patient is taken to a hospital with intravenous thrombolytic capability and conditions, the opportunity is already lost. 2. The complications of bleeding make doctors and patients cautious. Thrombolytic drugs often cause bleeding, ranging from mild subcutaneous and mucosal bleeding to gastrointestinal bleeding to the most serious intracranial and myocardial bleeding. This bleeding is also related to the patient’s underlying cardiovascular disease, age, gender, and other factors. If thrombolysis coincides with these potential risk factors, the occurrence of bleeding may increase disability and mortality; if overthought, effective treatment may be delayed. 3. It is imperative to study thrombolytic drugs with high efficacy and few adverse effects. For example, all thrombolytic drugs dissolve the fibrin in the thrombus, but do not target the clot itself, and the small clot decomposed by the thrombus can still cause microvascular embolism, leading to severe myocardial ischemia or focal myocardial infarction. To sum up, patients with coronary heart disease and their families should learn the medical common sense of acute myocardial infarction, and when acute myocardial infarction is suspected, they must go to the hospital with intravenous thrombolytic ability and conditions without losing time; in the hospital or onset site, when the physician clearly acute myocardial infarction, as long as the patients with indications and no contraindications, they should immediately take intravenous thrombolytic therapy, based on clinical observation and laboratory test indicators. Prevent and treat complications, and make every effort to improve the success rate of thrombolytic therapy.