title: [How many patients with acute myocardial infarction can be treated by thrombolysis?].
abstract: Thrombolytic treatment of acute myocardial infarction (MI) is limited by the time elapsed since onset, accuracy of the diagnosis and the presence of contra-indications. These factors were prospectively investigated in 173 consecutive patients with proven acute MI, admitted to a city hospital between July and December 1986. Fifty-eight patients (35%) were admitted within three hours of onset of symptoms. Delay in calling a doctor or ambulance was significant: 50% of patients waited for more than two hours after onset of symptoms, 40% more than three hours. Duration of transport to hospital averaged 30 min. Infarct-typical angina of at least 30 min had been present in 143 patients (83%). Atypical symptoms and silent MI was more frequent in the older patients. Diagnostic ST segment elevation of 2 to 3 mm on admission was present in 59 (34%) patients. After consideration of contraindications, present in 120 patients with altogether 165 potential factors, thrombolytic treatment was possible in only seven (4%) of those with the greater ST elevations within three hours after onset of symptoms and 13 (7.5%) within six hours. The most frequent contraindications were age (over 75 years), hypotension, re-infarction at the same site, intramuscular injections (unspecified drugs) within the preceding seven days, or resuscitation with cardiac massage before admission.
authors.affiliation: I. Medizinische Abteilung des Allgemeinen Krankenhauses Harburg, Hamburg.
authors.forename: B
authors.initials: B
authors.lastname: Weiss
authors.forename: K
authors.initials: K
authors.lastname: Donat
authors.forename: J P
authors.initials: JP
authors.lastname: Bohe
mesh_terms: D000367:Age Factors; D000368:Aged; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents
vernacular_title: Wie viele Patienten mit akutem Herzinfarkt können mit Thrombolyse behandelt werden?