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

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

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

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