[Management of acute myocardial infarct with ST segment elevation]

In the management of acute myocardial infarction with ST segment elevation, the primary goal is rapid reperfusion of the initially occluded infarct-related coronary artery. This may be achieved either by catheter using direct coronary angioplasty or by medical therapy in form of thrombolysis. These two methods, their concomitant treatment strategies as well as most recent results of combination therapy are presented and discussed. This results in recommendations for the management of these patients which have to take into account logistic possibilities and minimize time delays.