Motion mode (M-mode) recording is an essential part of echocardiography to measure cardiac dimension and function. However, the current diagnosis cannot build an automatic scheme, as there are three fundamental obstructs: Firstly, there is no open dataset available to build the automation for ensuring constant results and bridging M-mode echocardiography with real-time instance segmentation (RIS); Secondly, the examination is involving the time-consuming manual labelling upon M-mode echocardiograms; Thirdly, as objects in echocardiograms occupy a significant portion of pixels, the limited receptive field in existing backbones (e.g., ResNet) composed from multiple convolution layers are inefficient to cover the period of a valve movement. Existing non-local attentions (NL) compromise being unable real-time with a high computation overhead or losing information from a simplified version of the non-local block. Therefore, we proposed RAMEM, a real-time automatic M-mode echocardiography measurement scheme, contributes three aspects to answer the problems: 1) provide MEIS, a dataset of M-mode echocardiograms for instance segmentation, to enable consistent results and support the development of an automatic scheme; 2) propose panel attention, local-to-global efficient attention by pixel-unshuffling, embedding with updated UPANets V2 in a RIS scheme toward big object detection with global receptive field; 3) develop and implement AMEM, an efficient algorithm of automatic M-mode echocardiography measurement enabling fast and accurate automatic labelling among diagnosis. The experimental results show that RAMEM surpasses existing RIS backbones (with non-local attention) in PASCAL 2012 SBD and human performances in real-time MEIS tested. The code of MEIS and dataset are available at https://github.com/hanktseng131415go/RAME.