Medical Health Encyclopedia

Thrombolytic therapy

By dissolving the clot, the blood is able to start flowing again to that area of the heart. If the blood flow to the heart is started again rapidly, it may prevent long-term damage to the heart muscle and may even stop an event that could have been fatal.

The drug is successful in restoring some blood flow to the heart muscle in approximately 75% of patients, but the resultant blood flow may not be entirely normal. Further therapy, such as cardiac catheterization, may be needed.

Physicians base their decisions about whether to give tPA for a heart attack on many factors, including a history of chest pain and the results of an ECG test.

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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.

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.