To summarize the nursing experience of a patient with acute myocardial infarction caused by spontaneous coronary artery dissection in the second trimester of pregnancy. Nursing points included close monitoring during PCI to ensure the safety of patients and fetuses，implementing position management to prevent blood reflux obstruction，objective-oriented volume management to prevent heart failure，precise dual drug care and early identification of bleeding risk，strengthening prenatal fetal monitoring and being alert to intrauterine hypoxia，the implementation of early rehabilitation to improve cardiac function，application of binary psychological support to alleviate negative emotions，targeted nutritional support to correct malnutrition. Capacity management was the focus and difficulty of the case. After treatment and nursing，the patient ’s condition improved and was discharged on the 11 th day after operation，and a healthy baby girl was born 3 months later，with good maternal and infant outcomes.