Absolute Contraindications and Cautions for Fibrinolysis in STEMI

Absolute Contraindications and Cautions for Fibrinolysis in STEMI

• Any prior intracranial hemorrhage

 • Known structural cerebral vascular lesion (e.g., arteriovenous malformation)

• Known malignant intracranial neoplasm  (primary or metastatic)

• Ischemic stroke within 3 months EXCEPT  acute ischemic stroke within 3 hours

   NOTE: Age restriction for fibrinolysis has been removed compared with prior      guidelines.

Contraindications and Cautions  for Fibrinolysis in STEMI

Absolute  Contraindications

• Suspected aortic dissection

• Active bleeding or bleeding diathesis (excluding menses)

• Significant closed head or facial trauma within 3 months

Έλεγχος αποτελεσματικότητας

It is reasonable to monitor the pattern of ST elevation,

cardiac rhythm and clinical symptoms over the 60 to 180

minutes after initiation of fibrinolytic therapy.

Noninvasive findings suggestive of reperfusion include:

• Relief of symptoms
• Maintenance and restoration of hemodynamic and/orelectrical instability  
• Reduction of ≥ 50% of the initial ST'segment elevation pattern on follow'up ECG 60 to 90 minutes after initiation of therapy.