Background: ST-elevation myocardial infarction (STEMI) is a life-threatening medical emergency characterized by complete occlusion of a coronary artery, leading to myocardial ischemia and subsequent tissue damage. Over the years, significant advancements have been made in the diagnosis and management of this condition, resulting in improved outcomes. Case illustration: A 51-year-old man presented to the emergency department with a chief complaint of chest pain like being crushed by a heavy object since two hours before admission, not relieved by rest. Electrocardiograph (ECG) examination showed ST-elevation in leads III and avF, and ST depression in leads V2-V6 indicating acute myocardial infarction in the inferior and posterior areas. Fibrinolytic was administered to the patient with streptokinase 1,500,000 units in 1 hour. Durante and post fibrinolytic electrocardiograph examinations were performed, and ST waves were found to decrease in leads II and avF and ST depression waves were reduced in leads V2-V6 The patient had no complaints on the third day of hospitalization. Patient diagnosed with Inferoposterior STEMI post successful fibrinolytic. Discussion: Fibrinolytic therapy aims to restore coronary blood flow by dissolving thrombi responsible for coronary artery occlusion. Fibrinolytic therapy should be started as soon as feasible for best benefits ideally, this means during the first three to six hours and maybe up to twelve hours after the onset of symptoms. The administration of fibrinolytics in this case resulted in successful reperfusion of the occluded coronary artery, as evidenced by the resolution of ST-segment elevation on subsequent ECGs. Conclusions: Although primary PCI is considered the gold standard treatment for STEMI, fibrinolytic therapy remains a viable and potentially life-saving alternative, particularly in settings where immediate invasive interventions are not readily accessible. Keyword: STEMI, Fibrinolytic, Myocardial Infarction, Acute Coronary Syndrome Abstract: Background: ST-elevation myocardial infarction (STEMI) is a life-threatening medical emergency characterized by complete occlusion of a coronary artery, leading to myocardial ischemia and subsequent tissue damage. Over the years, significant advancements have been made in the diagnosis and management of this condition, resulting in improved outcomes. Case illustration: A 51-year-old man presented to the emergency department with a chief complaint of chest pain like being crushed by a heavy object since two hours before admission, not relieved by rest. Electrocardiograph (ECG) examination showed ST-elevation in leads III and avF, and ST depression in leads V2-V6 indicating acute myocardial infarction in the inferior and posterior areas. Fibrinolytic was administered to the patient with streptokinase 1,500,000 units in 1 hour. Durante and post fibrinolytic electrocardiograph examinations were performed, and ST waves were found to decrease in leads II and avF and ST depression waves were reduced in leads V2-V6 The patient had no complaints on the third day of hospitalization. Patient diagnosed with Inferoposterior STEMI post successful fibrinolytic. Discussion: Fibrinolytic therapy aims to restore coronary blood flow by dissolving thrombi responsible for coronary artery occlusion. Fibrinolytic therapy should be started as soon as feasible for best benefits ideally, this means during the first three to six hours and maybe up to twelve hours after the onset of symptoms. The administration of fibrinolytics in this case resulted in successful reperfusion of the occluded coronary artery, as evidenced by the resolution of ST-segment elevation on subsequent ECGs. Conclusions: Although primary PCI is considered the gold standard treatment for STEMI, fibrinolytic therapy remains a viable and potentially life-saving alternative, particularly in settings where immediate invasive interventions are not readily accessible.

Acute Coronary Syndrome

Myocardial Infarction

STEMI

Fibrinolytic