رجل عمره ٥٨ سنة عنده احتشاء STEMI في الجدار السفلي، وأقرب مركز قسطرة على بعد ٣ ساعات، فأُعطي مذيب جلطة. قبل الدواء كان الألم ٩/١٠ مع ارتفاع ST واضح. بعد ٤٥ دقيقة أي ملاحظة تدل على نجاح فتح الشريان؟

A 58-year-old man with inferior STEMI is 3 hours from the nearest cath lab and receives a fibrinolytic. Before the drug his pain was 9/10 with clear ST elevation. Which finding 45 minutes later indicates successful reperfusion?

1. Pain resolution with a brief run of accelerated idioventricular rhythm
2. BP falling to 80/40 with cold extremities
3. Persistent pain with further ST elevation in the same leads
4. Mild gum bleeding and bruising at the cannula site

Answer: A) Pain resolution with a brief run of accelerated idioventricular rhythm. Signs of reperfusion are pain relief, marked ST resolution and reperfusion rhythms such as accelerated idioventricular rhythm, which usually needs no treatment. Minor bleeding is a side effect, not proof of success.