Background: Coronary Artery Disease is on the increase. Management within guideline indicated early apt treatment is critical for successful outcomes.

Methods: 50 year old male who presented with chest pain at a peripheral out-patient clinic. The past medical history was not significant and his risk factors were age, gender and tobacco use. An electrocardiogram revealed diagnosis of ST Elevation Myocardial Infarction,and thrombolysis with streptokinase was administered at the clinic as primary angioplasty was not accessible.

Conclusion: Thrombolysis treatment when offered at the first point of medical contact, is a life saver and is the accepted standard management. All medical facilities should be equipped with necessary medication to treat acute coronary syndromes.