Despite advances in thrombolytic treatment of acute infarction in a major proportion of patients occasionally despite its administration reperfusion of the heart muscle does not occur which implies a negative impact on the long-term prognosis of these patients. With regard to the fact that invasive diagnostic methods are not available in the field, the basis of non-invasive diagnosis and stratification of patients for further reperfusion treatment is assessment of the symptomato- logy (chest pain) and frequent controls of 12-lead ECG, although controlled trials evaluating their validity for decisions in acute situations are not quite unequivocal. With the development of quantitative bedside enzyme diagnosis it may be anticipated that it will play a more important part in the differentiation of reperfusion failures. The basis of diagnosis in thrombolysis failure is in contemporary clinical practice simultaneous evaluation of all available non-invasive indica- tors.

        Key words: Failure of thrombolysis - Diagnosis - Non-invasive methods - Prognostic value.