Thrombolytic therapy

Other factors used to determine if someone is a good candidate for tPA include age, medical history, gender, history of previous heart attack, history of diabetes, history of low blood pressure, or increased heart rate, and if the person is elderly (older than 70 years).

Generally, tPA will not be given if the person has had a recent head injury, trauma, surgery, bleeding problems, uncontrolled high blood pressure, bleeding ulcers, or pregnancy.

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STROKE

Close to 80% of all strokes are ischemic strokes, caused when blood clots form in one place in the body and travel to a smaller blood vessel in the brain, blocking the blood flow to that area.

For strokes of this nature, tPA can help dissolve the clot quickly. Often, tPA can limit the amount of permanent disability that can result from an ischemic stroke, especially if given within 3 hours of the initial symptoms of the stroke.

The decision to administer the drug is based upon the history, physical exam consistent with a significant stroke, and a brain CT scan to exclude bleeding.

If someone is having a hemorrhagic stroke or a stroke caused by bleeding in the brain, tPA is not given because this could worsen the stroke by causing increased bleeding.

Ischemic strokes often occur when a person is at rest or not under physical duress. Hemorrhagic strokes often occur during some sort of physical exertion. In some cases, the diagnosis of the actual type of stroke may be difficult and the risk of bleeding from tPA is a concern. Generally, the benefits of receiving it outweigh the risks if given in a timely manner.

RISKS

Hemorrhage or bleeding is the most common risk associated with the administration of tPA therapy. Bleeding which is mostly minor, such as gum or nose bleeding, can occur in approximately 25% of people, while bleeding into the brain occurs approximately 1% of the time. This is true for both stroke and heart attack patients.

CONTACT A HEALTH CARE PROVIDER OR CALL 911

The key for people suffering from a heart attack or a stroke is recognizing that both conditions are medical emergencies. The sooner transportation and treatment with tPA takes place for acceptable candidates, the better the chance that person has for a good outcome.

Refer to the stroke and heart attack articles for specific symptoms for both conditions. If you suspect you or someone you know is suffering from symptoms of a heart attack or stroke, you should seek help immediately!