Early management of acute myocardial infarction: Thrombolysis, angioplasty, and adjunctive therapies

Early identification and treatment, including administration of intravenous thrombolytics, coronary angioplasty, and adjunctive therapies, has been shown to benefit patients who present with acute myocardial infarction. However, only a small percentage of these patients receive such therapies because of late presentation, associated risks, and controversies surrounding certain myocardial infarct subsets. The logistics involved in carrying out these treatments have resulted in unnecessary prehospital and in-hospital delays. These issues make essential the availability of a streamlined protocol that should be updated at regular intervals to ensure that these time-dependent therapies are more routinely and rapidly utilized. This article discusses these topics in conceptual format and provides a ready-to-use protocol.