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Reperfusion of the Heart Muscle: Dissolution of clot (clot-busting) is the most important step in the treatment of myocardial infarction. There are agents like streptokinase, urokinase, alteplase, reteplase which dissolve the clot in the coronary artery of the heart and providing reperfusion. Urokinase, alteplase and reteplase are very expensive. Streptokinase is less expensive but can cause allergy in patients with history of sore throat due to streptococal infection. High level of antibodies may render it ineffective. Urokinase (DEBUNASE) has also become cheaper and it can be used in those who are allergic to streptokinase. Each of these drugs may cause bleeding. They are not used in very high BP, pregnancy and recent surgery. If hazards of thrombolytics are high, immediate angioplasty (opening by probes) of infarct related artery is done… Continue reading