Objective To explore the effects of different contrast acoustic scores (CSI) on serum troponin I (cTnI), cardiac fatty acid binding protein (H-FABP) and creatine kinase isoenzyme (CK-MB) levels in patients with acute myocardial infarction (AMI) and their correlation with cardiac ultrasound characteristics. Methods Ninety patients with AMI admitted to our hospital from March 2019 to March 2021 were selected. All patients received myocardial contrast acoustic examination (MCE), and the examination results were used as the evaluation criteria for the myocardial perfusion level of patients. According to the patients' CSI, all patients were divided into group A (CSI≥0.75, n=50) and group B (CSI<0.75, n=40). All patients underwent cardiac ultrasound examination to detect the levels of serum markers of myocardial injury such as cTnI, H-FABP and CK-MB, and to explore the correlation between the characteristics of cardiac ultrasound and the level of myocardial perfusion. Results There were statistical differences in LA, LVD, LVEF, E, A, E/A between the two groups, and the values of LA, LVD in group B were higher than those in group A, and the values of E, A, E/A, LVEF were lower than those in group A (P<0.05), but there was no statistically significant difference in LVMI between the two groups (P>0.05). There were statistical differences in the levels of cTnI, H-FABP and CK-MB between the two groups, and the levels in group B were higher than those in group A (P<0.05). Correlation analysis showed that the levels of LA, LVD and LVEF were negatively correlated with the level of myocardial perfusion, while E and E/A were positively correlated with the level of myocardial perfusion. Conclusion There is a correlation between cardiac ultrasound characteristics and myocardial perfusion level in AMI patients, the lower the CSI score, the higher LA, LVD, LVEF levels, and lower E and E / A values, and the higher the level of myocardial injury markers