indications
Last reviewed 01/2018
The indications for thrombolysis include:
- chest pain consistent with myocardial infarction
- ECG changes:
- ST-segment elevation > 0.1mV in at least 2 contiguous leads
- new or presumably new left bundle branch block
- ST-segment depression with prominent R wave in leads V2 and V3, if this is thought to indicate a posterior infarction (benefit is doubtful if it is thought to indicate unstable angina)
- time from onset of symptoms:
- less than 6 hours - most beneficial
- 6 - 12 hours -lesser but still important benefits.
- after 12 hours - diminishing benefits but possibly still useful for continuing chest pain or 'stuttering' pain course
- age:
- physiologic age more important than chronologic age
- under 75 years - clear-cut benefits
- older than 75 years - fewer clear-cut benefits