Abstract

 BACKGROUND:
Acute myocardial infarction is a major cause of death throughout the world. Many important advances
have become available to Coronary Care Units enabling them to reduce mortality and improve the
prognosis, Reperfusion therapy is one of these important advances.
OBJECTIVE:
This study sought to identify the Electro-cardiographic (ECG ) changes which occur after receiving
Alteplase therapy and its relation to response to thrombolytic therapy.
METHODS :
Seventy-three patients with ST- elevation Acute Myocardial Infarction (AM I) who received Alteplase
within 12 hours from the start of symptoms in coronary care unit were included in this study. Electrocardiographic (ECG) was done to all patients at time of arrival to the coronary care unit(CCU),
Alteplase therapy was given to all patients plus heparin intravenously, followed by electrocardiographic (ECG ) every 30 minutes for 2 hours.
RESULTS:
Fifty-seven and half percent of our patients showed 50% reduction in the ST segment elevation in the
worst lead after 2 hours from starting Alteplase therapy and regarded as responders. Other ECG
changes like rapid appearance of Q wave, T inversion, accelerated idioventricular rhythm (AIVR) are
found to be specific for reperfusion with a high predictive value when the gold standard criteria was
reduction 50 % in the ST segment elevation Resolution of reciprocal changes is sensitive and specific
with high predictive value.
CONCLUSION :
Some ECG changes after thrombolytic therapy can predict the response in addition to the already
known changes.