Echocardiography and rescue angioplasty are effective for high risk patients

EDITOR—Lim and Shiels state that pooled data suggest patients do not benefit from rescue angioplasty after failed thrombolysis and that their outcome is adversely affected when interventional techniques fail to open the vessel affected by the infarct.1 They also state that “vigorous clinical assessment” is required before a patient can be classified as high risk after thrombolytic treatment to prevent misinterpretation of signs such as hypotension and sinus tachycardia. Both points should be addressed.

Firstly, the only large scale randomised trial comparing rescue angioplasty …