What finding indicates satisfactory response to thrombolytic therapy in a patient with acute myocardial infarction?

The indication of a satisfactory response to thrombolytic therapy in a patient with an acute myocardial infarction is the improvement in ECG readings. Thrombolytic therapy aims to dissolve the blood clot obstructing the coronary artery, which enhances blood flow to the heart muscle. This restoration of blood flow can be evidenced by changes in the ECG, particularly the resolution of ST segment elevation or the appearance of negative T waves, indicating reperfusion.

While aPTT being two times the control may suggest effective anticoagulation, it does not directly correlate with the success of thrombolytic therapy in terms of reperfusion. Monitoring coagulation parameters is important, but clinical evidence of heart muscle recovery is the primary goal of thrombolytic treatment.

Reduction in chest pain can indicate improvement; however, this symptom may not encompass the full extent of myocardial salvage or reflect the underlying electrical activity and potential ischemia detected on an ECG. Therefore, the best indicator of a satisfactory response to thrombolytic therapy is the documented improvement in ECG readings, confirming enhanced myocardial perfusion.