Cardiovascular disease (CVD) is the leading cause of death worldwide, being coronary events the most common cause of CVD. In the case of an acute ST-segment elevation myocardial infarction, the conventional treatment involves the reperfusion of the culprit artery as soon as possible as angioplasty has replaced the thrombolysis therapy.

We present two patients with acute ST-segment elevation myocardial infarction. The first patient showed an STsegment elevation of the anterolateral wall, and the second one, in the inferolateral wall. In both cases we performed rapid reperfusion with thrombolytics (ischemic time less than 30 minutes), with good response.

The first patient showed a lesion in the subendocardial myocardium in the late gadolinium enhancement in cardiovascular magnetic resonance imaging.

Taking into account the time delays of patients-derivation and door-to-balloon time in developing countries, these cases reinforce the indication of thrombolytics as the treatment of choice.