reece ol ee a eMC Arete CON Toi (US ee cRer Gee) Se ee re aint hme eee = ere a ee] ane tera e coch aee a INTRODUCTION © “Myocardial infarction (M_) denotes the death of cardiac myocytes due {0 extended ischemia, Myocardial reperfusion is the restoration Of cordhary blood flow afler a period of coronary occlusion and can be done by means of pharmacology by giving fibrinolytics agents or by mechanical reperfusion with primary PCL. In this ease prgbentation we would ike to discuse about PRE fibrnolytics and its se in ate proventor ST elevation Myocardial Infarction (STEMI) im the hospital with no Primary PCI facility. . FIBRINOLYTIC ‘Since GISSI-1 beeame the first to convincingly show the effect of fibrinolytic therapy, EMERAS and LATE trial showed no mortality benefit when Gbrinolytics weze routinely administered to Acute MI patients between 12-24 hours. FIT tial: A statistically uncertain bénelit of about 10 per 1000 for ‘hogileeraay™ 15-10 1 ‘Kloner RA, etal. Consequences of bret ischemia: stunning, preconationing, ‘and their incl iplieations: part 1. Crculabon. (2001) TTE AFTER HOSPITALIZATION FOLLOW UP A.case of 45 years old gentleman visiting ED with chief complaint of chest pain 14 hours prior to admission. The pain characteristic was consistent to Ml. The night before, he initially sought no medical attention and rest at his home. Afterwards in the morning, the pain was felt again with the scale of 8/10 and his| wife took him to ED. His ECG showed anterior extensive MI ‘echo showed LVEF of 48% with RWMA according to his infarcta areas. We decided to perform fibrinolysis with 1.8 millions Il intravenous Steptokinase. In the process there were biges VPC, no other major complicati® of lytics were observed. Afterwards the pain was decreasing to 4/10 and ECG evolved to Q wi We continued with anticoagulation by giving Fondap: ‘Then in his next 24 hours, the pain was resolved to 0/| third day of hospitalization, the echo was reevaluated, was discharged home with dual antiplatelet, statin, ACE-I, and beta blocker. ECG ON ADMISSION of symptoms onset and alarge area of is pain after the “oopoents ett 19M op “ary Bae irra ta at ng pe