Contraindications to Fibrinolytic Therapy for STEMI

Absolute contraindications

Suspected aortic dissection

Previous hemorrhagic stroke or intracranial hemorrhage

Previous ischemic stroke within 3 months (except acute ischemic stroke)

Malignant intracranial tumor

Known cerebrovascular malformation

Intracranial or intraspinal surgery within 2 months

Closed head or facial trauma within 3 months

Active bleeding (not menses) or bleeding diathesis

Blood pressure > 180/110 mm Hg unresponsive to antihypertensive therapy

Relative contraindications

Chronic, severe, or poorly controlled hypertension or blood pressure > 180/110 on presentation

Prior ischemic stroke > 3 months

Active peptic ulcer

Pregnancy

Bleeding diathesis

Noncompressible vascular puncture

Oral anticoagulant therapy

Dementia

Intracranial pathology not listed under absolute contraindications

Traumatic or prolonged cardiopulmonary resuscitation (CPR)

Major surgery within 3 weeks

Internal bleeding within 2–4 weeks