Which condition is an indication for fibrinolytic therapy in ACS management?

Which condition is an indication for fibrinolytic therapy in ACS management?

• A. STEMI
• B. NSTEMI
• C. Unstable Angina
• D. Variant Angina

Answer: (A)

In fibrinolytic therapy for ACS, the key indication is an acute ST-elevation myocardial infarction. That ECG pattern means a complete occlusion of a coronary artery with ongoing transmural ischemia, where dissolving the clot can promptly restore blood flow and limit heart muscle damage. Fibrinolytics are most beneficial when given as early as possible after symptoms begin, ideally within the first few hours. If a patient can have primary PCI quickly, that approach is usually preferred because it more reliably reopens the artery and carries a lower bleeding risk compared with fibrinolysis. For non‑ST elevation ACS—NSTEMI and unstable angina—the problem is not a persistent ST‑segment elevation from a complete occlusion, so fibrinolysis does not provide a benefit and is avoided to prevent unnecessary bleeding. Variant angina is due to coronary vasospasm rather than a thrombotic occlusion, so vasodilator therapy is the approach and fibrinolysis isn’t indicated.

In fibrinolytic therapy for ACS, the key indication is an acute ST-elevation myocardial infarction. That ECG pattern means a complete occlusion of a coronary artery with ongoing transmural ischemia, where dissolving the clot can promptly restore blood flow and limit heart muscle damage. Fibrinolytics are most beneficial when given as early as possible after symptoms begin, ideally within the first few hours.

If a patient can have primary PCI quickly, that approach is usually preferred because it more reliably reopens the artery and carries a lower bleeding risk compared with fibrinolysis. For non‑ST elevation ACS—NSTEMI and unstable angina—the problem is not a persistent ST‑segment elevation from a complete occlusion, so fibrinolysis does not provide a benefit and is avoided to prevent unnecessary bleeding. Variant angina is due to coronary vasospasm rather than a thrombotic occlusion, so vasodilator therapy is the approach and fibrinolysis isn’t indicated.