〔Abstract〕 Myocardial ischemia is an important pathological change in coronary heart disease. A decrease in blood flow perfusion puts the myocardium in a state of ischemia and hypoxia, leading to abnormal energy metabolism and varying degrees of decreased cardiac function. In severe cases, it can induce adverse events such as myocardial infarction and sudden death. The most severe type of myocardial ischemia after acute myocardial infarction (AMI) is coronary heart disease, with chest pain, breathing difficulties, chest tightness, and vomiting as the main clinical symptoms. If not actively treated, it can cause arrhythmias and increase the risk of sudden death. In clinical practice, reperfusion therapy is the main method of treating AMI. Through thrombolytic drugs, interventional therapy, or surgical treatment, reperfusion therapy reopens completely occluded blood vessels, allowing ischemic tissue to achieve reperfusion. Timely revascularization therapy can restore blood supply in a short period of time, but it can also lead to varying degrees of ischemia-reperfusion injury (IRI), damaging the structure and function of the myocardium, and is considered a major event that affects the effectiveness of reperfusion therapy in patients with coronary heart disease. At present, research has found that myocardial ischemia-reperfusion injury (MIRI) is related to mechanisms such as oxidative stress, Ca²⁺ overload, energy metabolism disorders, and inflammatory reactions. Drug therapy focuses on relevant mechanisms to protect MIRI, such as combating oxygen free radicals, inhibiting calcium overload, improving inflammatory infiltration and cell apoptosis, and alleviating mitochondrial damage. At present, the treatment of reperfusion injury with Western medicine is at a bottleneck, and the author attempts to introduce the theory of traditional Chinese medicine. According to the perspective of traditional Chinese medicine, AMI can be classified into the categories of "heartache" and "chest obstruction". The disease is located in the heart, involving many organs such as the liver, spleen,and kidney. The pathogenesis is seen in qi deficiency and blood stasis, and it is recommended to use the methods of nourishing qi to remove obstruction and promoting blood circulation to remove stasis. Therefore, exploring the pathogenesis of reperfusion injury from the perspective of integrated traditional Chinese and Western medicine theory and systematically summarizing the possible main mechanisms of reperfusion injury in traditional Chinese and Western medicine is of great clinical significance for the prevention and treatment of IRI.