Acute stroke with concomitant acute myocardial infarction: will you thrombolyse?

Maciel, Rita; Palma, Raquel; Sousa, Pedro; Ferreira, Fatima; Nzwalo, Hipólito

http://hdl.handle.net/10400.1/11361

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Abstract(s)

Concomitant occurrence of acute myocardial infarction (MI) and stroke is infrequently encountered in emergent patients. Acute MI within the previous 3 months is considered a relative contraindication for therapy with alteplase or intravenous tissue plasminogen activator (IV rtPA).1 The use of IV rtPA for stroke in patients with a recent MI is associated with an increased risk of cardiac rupture, secondary to breakdown of the existing fibrin clot within the necrotic myocardium and/or degradation of collagen2 . Whether it is appropriate to perform thrombolysis in an emergent patient with concomitant ischemic stroke and MI remains a matter for debate.