The lack of facilities sometime blocks the use of thrombolytic therapy in public hospitals. In this report, initial experience with the use of thrombolytics in a Municipal Hospital located in São Paulo suburb area, which has no hemodynamic laboratory available, is reported. Prospectively, 45 patients admitted to the adult medicine care unit with acute myocardial infarction from Dec/93 to May/94 were evaluated. Twenty four patients were submitted to thrombolytic therapy by streptokinase (SK), 1.500.00 units IV in the peripheral vein.

They showed the following signs of reperfusion:

relief of pain, rapid resolution of ST-segment elevation, reperfusion associated arrhythmias and early enzymatic peak (CK-MB). Seven deaths were recorded, six of them did not receive SK. The use of thrombolytic, even in hospitals without haemodynamic laboratory, has contributed to the decrease of mortality. Thus, this therapy should be used as early as possible in acute myocardial infarction.