Which is a contraindication to fibrinolytic therapy?

Which is a contraindication to fibrinolytic therapy?

• A. Head trauma in last 3 months
• B. History of MI
• C. Controlled HTN
• D. Hyperlipidemia

Answer: (A)

Giving a thrombolytic carries a strong bleeding risk, especially in the brain. A head trauma within the last three months indicates possible intracranial injury or a vulnerable area that could bleed if a fibrinolytic is used. Administering a thrombolytic in this setting can provoke a catastrophic intracranial hemorrhage, which is why recent head trauma is an absolute contraindication to fibrinolytic therapy. The other conditions listed do not inherently prohibit fibrinolysis: a history of myocardial infarction is common in patients treated with thrombolytics, and controlled hypertension and hyperlipidemia do not by themselves create the bleeding risk seen with recent brain injury.

Giving a thrombolytic carries a strong bleeding risk, especially in the brain. A head trauma within the last three months indicates possible intracranial injury or a vulnerable area that could bleed if a fibrinolytic is used. Administering a thrombolytic in this setting can provoke a catastrophic intracranial hemorrhage, which is why recent head trauma is an absolute contraindication to fibrinolytic therapy.

The other conditions listed do not inherently prohibit fibrinolysis: a history of myocardial infarction is common in patients treated with thrombolytics, and controlled hypertension and hyperlipidemia do not by themselves create the bleeding risk seen with recent brain injury.