Background: The roots of Panax vietnamensis Ha et Grushv. (PV) are used in the preparation of local drugs to treat cardiovascular and cerebrovascular diseases. However, it is still not clear if the saponins extracted from PV show a protective effect against myocardial injury, and if so, what are its primary active ingredients. Materials and Methods: In this study, a rat model of ischemic myocardial injury induced by isoproterenol was established, and the effect of PV saponin extract (PVS) on the heart rate and changes in the S-T segment were studied. The compounds were isolated through chromatographic techniques. H9c2 damaged cells, after induction by H2O2, were established and then treated with ocotillol-type ginsenosides at a concentration of 0.5, 1, 3, 10, and 30 μg/mL. Then, the cell viability, rate of cellular apoptosis, and apoptosis-related protein expression levels were detected by MTT assay, flow cytometry, and Western blot analysis. Results: PVS inhibited the elevation in the S-T segment and heart rate in rats with myocardial ischemia induced by isoproterenol. Four ocotillol-type ginsenosides and six dammarane-type ginsenosides were isolated from the PVS. Ocotillol-type ginsenosides compounds 1, 2, and 3 showed the effect of increasing the cell viability of H9c2 cardiomyocytes after induction with H2O2, and of them, compound 3 showed the strongest activity. Furthermore, compound 3 significantly inhibited the apoptosis of H9c2 injured cells, decreased the expression level of Bax and caspase 3, and increased the expression level of Bcl-2. Conclusion: PVS shows positive effect against myocardial injury. Compound 3 isolated from PVS protected H9c2 cells from damage caused by H2O2 by inhibiting apoptosis. These results will provide an important reference for the treatment of coronary heart disease.