The patients came to our attention rather late; the time factor influenced the clinical evolution of our patients, not only in the acute phase, so we encountered more frequently conditions of cardiogenic shock with the need for hemodynamic and respiratory support, but also in the subsequent intrahospital course we documented complications clearly related to large infarct sizes due to patient’s delay such as left ventricular thrombus. The increased mortality caused by acute myocardial infarction in this recent period of time has also been shown by other studies. Myocardial infarction during Covid-19 pandemic represents a dramatic dip into the past: our data confirm not only an increase in mortality for acute myocardial infarction, but also in the rate of major complications and in the number of patients with severe left ventricular systolic dysfunction. It is fundamental to reassure patients that we have put the necessary precautions in place to prevent them from contracting Covid-19, but above all that we will have the necessary tools not only to face a new pandemic, but to continue to treat acute cardiac events also during a new critical phase. The emergency network has been rebuilt for all time-dependent cardiovascular diseases: we have organized an exclusive path for Covid-19 patients or suspected patients, with the use of two hemodynamics rooms, one of which is for the exclusive use for these patients and the presence of an intensive care area dedicated to their isolation and treatment.