ABSTRACT
ST segment elevation myocardial infarction (STEMI) is the leading cause of mortality in developed countries. When minutes count, and time is muscle, emergency physicians have the opportunity to have a relevant impact on morbidity and mortality by instituting appropriate therapy in a very timeeffi cient manner in the treatment of STEMI. Guidelines were promulgated to provide recommendations in an effort to standardize and optimize the evaluation, diagnosis, and management of patients with STEMI. These recommendations emphasize the importance of early reperfusion therapy. To achieve this goal, local networks have to be implemented, to promote early in-ambulance treatment, including thrombolysis or immediate transfer of the patient to a primary percutaneous coronary intervention (PPCI) hospital, avoiding delay in vessel reopening. However, even when thrombolysis is the preferred initial therapy, all patients should be transferred to PPCI centers in order to reduce the time to reperfusion where thrombolysis fails or early reocclusion occurs.
