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Indications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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