Streptokinase used in general practice.

Over a six-month study in general practice 43 patients were identified whose presenting symptom was chest pain thought to be cardiac in origin. The median time from the onset of pain to the general practitioner attending was 60 minutes. On the basis of history, examination and initial electrocardiogram these patients were assessed as unlikely or likely to be infarcting. Of this latter group 15 fulfilled the inclusion criteria for intravenous streptokinase, four commencing treatment at home and 11 on admission to the local general practitioner medical ward. Each received 1.5 mega units over 60 minutes. The median time from the onset of pain to the start of therapy was 120 minutes. Of the 28 patients clinically suspected of having sustained a myocardial infarct 24 proved positive--an over-diagnosis rate of 14%. No major problems were encountered following streptokinase.