Abstract
Thrombolytic treatment is the greatest advance in the management of acute myocardial infarction since the introduction of the defibrillator over 25 years ago. The purpose of this article is to give a balanced view of the evidence for the value of thrombolysins in acute myocardial infarction, and to weigh up the advantages and disadvantages of the different agents which are available. We need to decide which drug to use, who should administer the treatment and which patients should receive thrombolytic therapy. We also need to consider the value of adjuncts such as treatment with aspirin, heparin and the use of coronary angioplasty.