Thrombolytic Therapy

Your physician may want to give you a medicine that will help dissolve blood clots in your coronary arteries. This is called thrombolytic therapy. When given promptly, the clot dissolving medicine can sometimes restore blood flow to the heart and prevent tissue death. There are four types of blood dissolving agents which can be given. Examples are streptokinase, urokinase, tissue plasminogen activator (TPA), and anistreplase (EMINASE). The coronary artery usually opens within 30 to 90 minutes. After receiving the clot dissolving agent, blood flow to the heart increases, which improves the oxygen level to the heart with relief of symptoms. To be able to receive these agents, the patient's pain must have started within four hours and have lasted 30 minutes, not relieved with nitroglycerin.

Because thrombolytic therapy increases the risks of bleeding, these agents are not recommended in the following situations:

• recent surgical procedures
• pregnancy or recent delivery
• history of a stroke
• uncontrolled hypertension (high blood pressure)
• recent major trauma (less than 6 months)
• bleeding disorders
• prolonged cardiopulmonary resuscitation

Patients receiving thrombolytic therapy have an increased risk of bleeding, so they will be in the Intensive Care Unit for closer observation. Lab values (blood work) will be monitored more frequently due to the effects of the therapy.

Complications due to the clot dissolving agent (thrombolytics) include bleeding, arrhythmias (abnormal heart rhythms), hypotension (decreased blood pressure), hematomas, and hypersensitivity to the drug.