Here is a hand from "More Killing defence at Bridge" by Hugh Kelsey.
In the book, this isn't a MP hand. The defence kicks off with a ♥ and declarer holds up until the 3rd round and then takes a losing ♠ finesse. The point of the hand is that East, who can place South with ♦Q and ♣AQ must now switch to the ♣8 to present declarer with a decision - risk the ♣ finesse or hop up with the Ace and hope the ♦ come in. Very nice.
But I am interested in how one should play this sort of hand at MP. You are in the normal contract and have got what looks like the normal lead. You have 6 tricks on top, but if everything is right you might make all 13 tricks (eg ♥A, 4 ♠ tricks 5 ♦s and a ♣/♥ squeeze on West for the last 3). On other layouts the maximum number of tricks might be 12, 11 10, 9 or fewer!
So what thought processes should one go through at MP when the contract you are in isn't laydown, but even so there might be overtricks galore up for grabs?

Help

South opens the bidding and NS have an unopposed auction to 3NT.
West leads ♥4