[Repeated early systemic lysis in acute myocardial infarct with recurrent ventricular fibrillation]

A 46-year-old man sustained an extensive acute inferoposterior myocardial infarction with cardiogenic shock. Recurrent ventricular fibrillation was controlled and enlargement of the infarct prevented by systemic thrombolysis, first begun in the ambulance and later twice repeated. Coronary angiography demonstrated isolated 50% stenosis of the circumflex branch in a left-dominant coronary circulation. Subsequent ventriculography demonstrated normal left-ventricular function.