Fast Five Quiz: Myocardial Infarction Clinical Keys

Yasmine S. Ali, MD

Disclosures

November 13, 2020

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.

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....