Contraindications to fibrinolytics in STEMI - USMLE Forums
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Old 06-29-2010
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Heart Contraindications to fibrinolytics in STEMI

Ischemic stroke within three months is mentioned in both absolute and relative contraindications to fibrinolytic therapy in case of STEMI.

Is it absolute of relative contraindication?
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Old 06-30-2010
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That's a typo error in Kaplan notes, here's the correct list

Absolute contraindications
  • Prior intracranial hemorrhage (ICH)
  • Known structural cerebral vascular lesion
  • Known malignant intracranial neoplasm
  • Ischemic stroke within 3 months
  • Suspected aortic dissection
  • Active bleeding or bleeding diathesis (excluding menses)
  • Significant closed-head trauma or facial trauma within 3 months
Relative contraindications
  • History of chronic, severe, poorly controlled hypertension
  • Severe uncontrolled hypertension on presentation (SBP >180 mm Hg or DBP >110 mm Hg)
  • Traumatic or prolonged (>10 min) CPR or major surgery less than 3 weeks
  • Recent (within 2-4 wk) internal bleeding
  • Noncompressible vascular punctures
  • For streptokinase/anistreplase - Prior exposure (more than 5 d ago) or prior allergic reaction to these agents
  • Pregnancy
  • Active peptic ulcer
  • Current use of anticoagulant (eg, warfarin sodium) that has produced an elevated international normalized ratio (INR) >1.7 or prothrombin time (PT) >15 seconds
[Guideline] 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 8: Stabilization of the Patient with Acute Coronary Syndromes. Circulation. Dec 13 2005;112(Suppl IV):IV-89-IV-110. [Full Text].
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The above post was thanked by:
Dr. N Elham (07-03-2010), Karrar (07-01-2010)


Cardiology-, Internal-Medicine-

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