Indications

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