The author evaluated retrospectively the therapeutic effect of intravenous systemic thrombolysis by streptokinase in 24 patients with developing cardiogenic shock associated with myocardial infarction. Fourteen patients died while in hospital (58%) and 10 (42%) survived and were discharged after a suitable time in hospital. Serious arrhythmias were frequent already before thrombolysis (ventricular fibrillation 2X, AV block grade II and III 5X, atrial fibrillation 4X). After streptokinase administration in two patients ventricular tachycardia was recorded, twice significant ventricular extrasystoles and once AV block grade II. In none of the patients arrhythmia was the cause of death. No allergic reaction was recorded. One patient following cardiopulmonary resuscitation developed after thrombolysis haemorrhage into the chest wall from the site of injection into the subclavian vein, without further sequelae. Thirteen of the dead were subjected to necropsy which confirmed the clinical diagnosis: once a haemorrhagic infarction was found, once rupture of the heart with tamponade. In two instances coronary thrombosis was detected. Of the 10 discharged patients at the end of 1988 seven patients survived for a period of 1-8 years. From the described group it may be concluded that systemic thrombolysis in patients with developing cardiogenic shock associated with myocardial infarction is not associated with a higher incidence of side-effects and that in some of the patients with a very adverse prognosis, after streptokinase administration a change in the course of the disease occurred leading to improvement of the condition and discharge from hospital.

Keywords: Aged; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Myocardial Infarction /complications/; Retrospective Studies; Shock, Cardiogenic /drug therapy/; Streptokinase /administration & dosage/; Thrombolytic Therapy