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Management of Angina and Myocardial Infarction: Contraindications to Thrombolytics

by Carlo Raj, MD
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    00:01 and place a stent, then you have to do bypass surgery.

    00:02 Using thrombolytics, there is some absolute relative type of contraindications, but keep in mind, before we move on here, if your patient is already in a state of bleeding why would you want to use a thrombolytic? That is just going to exacerbate the issue. It might actually kill your patient. Who are my patients? Hemorrhagic strokes, non-hemorrhagic stroke past three months, intracranial neoplasia, active internal bleeding, aortic dissection, closed head or facial trauma, once again for three months. Now take a look at some of these. If the patient is already at risk for severe bleeding, by adding a thrombolytic, these are absolute contraindications for then using a thrombolytic now. This is absolute for any licensing exam. In clinical practice, you might always find that attending who might be extremely confident in his or her ability to still give a thrombolytic in such situations, but that is not being asked here nor is it going to be asked on your boards. Relative, severe hypertension, proliferative diabetic retinopathy, what does that mean to you? You are thinking about the eye and when undergoes proliferation, you want to be careful though because what might you do? By thrombolytic, you might then cause bleeding take place. Known bleeding diathesis, for example von Willebrand disease, prolonged CPR, allergic reactions, pregnancy, blood pressure, ulcers be careful there, please. Very careful actually, for example, when you use a thrombolytic at some point with that ulcer, there might be so much bleeding that you might actually bring about perforations.

    01:40 So please be careful when using such drugs. Contraindication for thrombolytics, absolute versus relative. Now, management continues. All patients with AMI should undergo intensive


    About the Lecture

    The lecture Management of Angina and Myocardial Infarction: Contraindications to Thrombolytics by Carlo Raj, MD is from the course Ischemic Heart Disease.


    Included Quiz Questions

    1. History of hemorrhagic stroke 2 years ago
    2. History of head trauma - 1 year ago
    3. Uncontrolled coagulation defects
    4. History of gastrointestinal bleeding 8 months ago
    5. History of non-hemorrhagic stroke 1 year ago
    1. Pregnancy
    2. Aortic dissection
    3. Hemorrhagic stroke
    4. Intracranial neoplasm
    5. Active internal bleeding

    Author of lecture Management of Angina and Myocardial Infarction: Contraindications to Thrombolytics

     Carlo Raj, MD

    Carlo Raj, MD


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