Thrombolytic Agents in Early Myocardial Infarction — An Overview in 1987

This paper reviews the current status of thrombolysis in early myocardial infarction. It may best be illustrated by an illustrative case. A 60-year-old technician was admitted at night with a 2-h history of persisting chest pain at rest associated with nausea and perspiration. He had been entirely well until 5 months previously, when he developed angina on effort. Despite 200 mg atenolol, 80 mg isosorbide dinitrate, and 40 mg nifedipine daily, anginal attacks increased in frequency and with less provocation, such as effort. They were, however, promptly relieved by nitroglycerin sublingually. On admission to the CCU, the angina pectoris did not respond to nitroglycerin and nifedipine sublingually. Blood pressure was 135/85 mmHg, heart rate 90 bpm and regular. There were no signs of congestive heart failure. The ECG upon admission suggested a large area of acute infero-posterior myocardial infarction. It was decided to attempt immediate and “optimal” reperfusion.