Einsatz der prähospitalen Lyse bei einer Patientin mit Vorderwandinfarkt und pulsloser ventrikulärer Tachykardie

This case report describes an 83-year-old patient with a known history of coronary heart disease suffering acute chest pain. The on-site emergency physician diagnosed acute anterior myocardial infarction and during the further course was confronted with pulseless ventricular tachycardia. After returning the heart’s normal rhythm by defibrillation, prehospital thrombolysis was performed to further stabilize the patient. This procedure makes transfer to the receiving hospital possible where further treatment can then be instituted. One-third of all patients suffering a heart attack die before ever reaching a clinic. Implementation of rules conforming to European and German guidelines on management of STEMI involves performance of percutaneous transluminal coronary angioplasty (PTCA) as the recommended standard. There must be strategies available to the attending emergency physician for on-site stabilization of those patients manifesting additional cardiac complications. Prehospital systemic thrombolysis represents a sensible measure for these cases.