Thrombolysis utilisation in acute myocardial infarction in Bahrain.

We retrospectively studied 114 consecutive patients of acute myocardial infarction diagnosed in the Accident and Emergency department of our hospital, to determine the percentage of eligible patients who actually received thrombolytic therapy, the number of those excluded from receiving such therapy and the various exclusion criteria. We found that 66 patients (57.9%) received thrombolysis with either streptokinase or tissue plasminogen activator (tPA). The remaining 48 (42.1%) were excluded because of delayed presentation to hospital after the onset of symptoms (23.7%), old age or other contraindications. Although the percentage of thrombolysis utilisation in acute myocardial infarction in our centre is much higher as compared to others in the world, we find that there is a scope for improving these figures by reducing the number of patients excluded because of late presentation through health education and improved utilisation of ambulance services.

Progressive systemic sclerosis presenting as recurrent ventricular tachycardia and hypertrophic cardiomyopathy--a case report.

A 39 year old male who presented with recurrent ventricular tachycardia developed features of progressive systemic sclerosis during the 4-year course of the illness. The condition was diagnosed during life with skin biopsy. Myocardial involvement was detected by 2-D echocardiography and was confirmed at autopsy.