Management of cardiac patients after thrombolytic therapy.

Abstract

Early thrombolytic therapy has significantly reduced morbidity and mortality through preservation of myocardium in patients with acute transmural myocardial infarction. Indications for emergent or early coronary angiography and possible angioplasty are generally limited to ongoing infarction and/or recurrent ischemia. Patients remaining clinically stable require risk stratification. Coronary angiography and revascularization with angioplasty or coronary bypass surgery is important for patients with exercise-induced ischemia. Patients with left ventricular dysfunction, poor or no exercise performance and/or advanced age are at higher risk for subsequent coronary events and thus warrant a more aggressive diagnostic approach.