Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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A 50 year old man presents to the ER within 3 hours of the onset of chest pain. He is nauseated and diaphoretic. ECG reveals evidence of an MI. PMH is significant for HTN that is controlled with medication, hypercholesterolemia, and a TIA 3 years ago.
1) Is this patient a candidate for thrombolytic therapy?
2) What are the contraindications to the use of thrombolytics?
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Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| darkhorse
Forum Elite
Topics: 56
Posts: 275
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yess...st elevation more than 2 mm in chest leads or st elevation more than 1 mm in one of limb leads
contraind are...bleeding diathesis, bleeding peptic ulcer, recent major surgery, recent hemorrhagic stroke, uncontrolled hypertension...i think there are many more
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When going gets tough, the tough gets going
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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I THINK ANY HISTORY OF TIA IS ACONTRAINDICATION OF THROMBOLYTICES
SO NOT CANDIDATE FOR IT 
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| cool doctor
Forum Junior
Topics: 1
Posts: 219
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I think he is a candidate if more than 6 months elapsed after the stroke
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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1) Thrombolytics should be given to this patient
2) Contraindications:
- Hx of CVS disease, uncontrolled HTN (>190/110), pregnancy, known bleeding diathesis, recent rauma of the head or spine, surgery or trauma within the previous 6 weeks, intracranial tumor, previous intracranial surgery, GI bleeding within the last 6 months, acute pericarditis, aortic dissection, current oral anticoagulation, prolonged CPR
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Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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