Place de l'angioplastie transluminale des coronaires dans le traitement l'infarctus du myocarde à la phase aiguë

Optimal treatment of acute myocardial infarction requires to rapidly re-open the coronary artery. Two ways have been described: fibrinolysis and coronary angioplasty. Angioplasty is indicated 1) in cardiogenic shock, 2) when a quick transportation toward a catheterism room is considered, 3) in case of diagnostic doubt, 4) when a previous fibrinolysis has failed. Otherwise, fibrinolysis may be initially proposed. Combined strategy may also been proposed.