The precise emotional process of middle-aged individuals after the onset of a first acute myocardial infarction（AMI）is not known. We sought to clarify the contents of middle-aged individuals’experience of having a first AMI. I interviewed with 11 individuals（10 men, 1 woman, aged 39 to 64 yrs）who had a first AMI about their AMI experience in the way of unstructured face-to-face interview. A qualitative phenomenological approach was used to clarify their experiences. Each individual described their psychological process from the point of experiencing the AMI through their recovery. They described facing their own potential death calmly. Their experiences could be classified as progressing through the following three phases over the course of their AMI onset, treatment and recovery. Phase 1：feeling of uncertain about their life and being upset, Phase 2：accepting life prospectively and thinking about self-control, and Phase 3：integrating their outlook for the future and their newly expanded view of life and death. The process of middle-aged individuals from onset to 3 months after a first AMI was very emotionally unstable. The results indicated a necessity for spiritual care promoting self-empowerment for patients with AMI.