PURPOSE Selection of patients with cerebral infarction for MRI that is suitable for thrombolytic therapy as an emerging application. Although the efficiency of the therapy with i.v. tissue plasminogen activator (tPA) within 3 hours after onset of symptoms has been proven in selected patients with CT, now these criteria are determined by MRI, as the data we gather are fast and accurate in the fi...

BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI) selection of stroke patients eligible for thrombolytic therapy is an emerging application. Although the efficacy of therapy within 3 hours after onset of symptoms with intravenous (IV) tissue plasminogen activator (tPA) has been proven for patients selected with computed tomography (CT), no randomized, double-blinded MRI trial has been pub...

Thrombolytic therapy salvages ischemic myocardium by rapidly reestablishing coronary artery patency in acute myocardial infarction. One of its major limitations is the complication of hemorrhage. A retrospective study of myocardial infarction patients who received thrombolytic therapy was performed to determine risk factors associated with a hemorrhagic event. Three hundred fifty patients were ...

Examination of 27 hearts from patients treated by streptokinase following myocardial infarction showed one major histopathological difference from controls, the presence of massive interstitial haemorrhage into the necrotic tissue in some cases. This change is presumably related to the re-establishment of the circulation to infarcted areas.

Case 1. A 65-year-old right-handed man with no history of heart disease presented to the emergency department with right-sided weakness and an inability to speak. His wife last saw him well 1 hour before his arrival. His ECG showed atrial fibrillation with a ventricular response of 100 bpm; his blood pressure was 175/ 88 mm Hg. He was alert, but he did not produce or comprehend speech. He did n...

Although thrombolytic therapy has been a major advance in the treatment of acute ST-segment elevation myocardial infarction (MI), new thrombolytic agents have been unable to improve early reperfusion. Because aspirin has been shown to be a very effective adjunctive agent in patients with acute MI, it has been hypothesized that the use of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors c...

Care of the patient with MI who receives thrombolytic therapy is an exciting challenge for the emergency nurse. By interrupting the process of cellular ischemia and necrosis, thrombolysis can salvage jeopardized myocardial tissue and lead to better patient outcome. Nursing interventions can help prevent possible complications of thrombolytic therapy, such as bleeding, dysrhythmias, and reocclus...

Intravenous thrombolytic therapy has become standard treatment for acute myocardial infarction (AMI). We describe three patients with long-standing seropositive rheumatoid arthritis (RA) on chronic corticosteroid therapy who experienced very early (1-6 h) mortality after the use of intravenous thrombolytic therapy for the treatment of AMI. All three patients likely experienced electromechanical...