EMERGENCY CASEBOOKS
Early administration of thrombolysis can prevent myocardial necrosis: time is myocardium
1 Department of Cardiology, Royal Surrey County Hospital, Guildford, UK
2 Department of Cardiology, The Heart Hospital, UCH, London, UK
3 Department of Cardiology, St George’s Hospital, Tooting, London, UK
4 Department of Cardiology, Royal Brompton Hospital, London, UK
Correspondence to:
Dr A Suri, Department of Cardiology, Royal Surrey County Hospital, Guildford, UK; mrajaysuri{at}hotmail.com
A case is presented in which a 66-year-old man received thrombolysis for an acute ST elevation myocardial infarction (STEMI) within 6 minutes of developing chest pain. An ECG performed 10 minutes after thrombolysis showed complete resolution of the ST segment elevation and showed no other abnormality. An echocardiogram showed normal left ventricular function and there was no detectable myocardial necrosis, as evidenced by two negative troponin assays. The case clearly reinforces the benefits of the rapid delivery of thrombolysis when appropriate for patients with STEMI. Clinicians need to be aware of the benefits of early thrombolysis as laid out in the national service framework. Evidence for the early administration of thrombolysis, data from the Myocardial Infarction National Audit Project and the future with regard to improving thrombolysis times are discussed.
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