Fast Five Quiz: Myocardial Infarction Clinical Keys

Absolute contraindications to fibrinolytic therapy in patients with STEMI include the following:

• Any prior intracranial hemorrhage

• Known structural cerebral vascular lesion

• Known intracranial neoplasm (primary or metastatic)

• Ischemic stroke within the past 3 months (except for acute stroke within 4.5 hours)

• Suspected aortic dissection

• Active bleeding or bleeding diathesis (excluding menses)

• Significant closed-head or facial trauma within 3 months

• Intracranial or intraspinal surgery within 2 months

• Severe uncontrolled hypertension (unresponsive to emergency therapy)

• For streptokinase (no longer marketed in the United States), treatment within the previous 6 months

Relative contraindications include the following:

• History of chronic, severe, poorly controlled hypertension

• Systolic blood pressure > 180 mm Hg or diastolic blood pressure > 110 mm Hg

• History of ischemic stroke > 3 months prior

• Dementia

• Known intracranial pathology not covered in absolute contraindications

• Traumatic or prolonged cardiopulmonary resuscitation lasting > 10 minutes

• Recent (within 2-4 weeks) internal bleeding

• Noncompressible vascular punctures

• Pregnancy

• Active peptic ulcer disease

• Current use of anticoagulants

• For streptokinase (no longer marketed in the United States), prior exposure (> 5 days previously) or prior allergic reaction to these agents

Read more about fibrinolytic therapy in patients with MI.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases article Myocardial Infarction.

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Yasmine S. Ali. Fast Five Quiz: Myocardial Infarction Clinical Keys - Medscape - Nov 13, 2020.