Patient education: Clot-dissolving medicines for heart attack or stroke (The Basics)

What are clot-dissolving medicines? — Clot-dissolving medicines are used for emergency treatment of a heart attack or stroke. Doctors call these "thrombolytic" or "fibrinolytic" medicines.

Most heart attacks and strokes happen because of blood clots:

●If a clot blocks a blood vessel going to the heart, it causes a heart attack.

●If a clot blocks a blood vessel going to the brain, it causes a stroke.

In both cases, the area gets damaged because it cannot get enough blood and oxygen. Breaking up or dissolving the blood clot can help limit this damage.

To be most helpful, clot-dissolving medicines should be given as soon as possible after a heart attack or stroke starts.

Who can take clot-dissolving medicines? — Clot-dissolving medicines are not safe for everyone. Doctors and nurses will work to quickly find out if a person can have clot-dissolving medicines.

If a person is having a heart attack, the doctor will consider the person's:

●Electrocardiogram ("ECG") results – This test measures electrical activity in the heart.

●Medical history

Certain conditions might make clot-dissolving medicines unsafe for a person having a heart attack. These could include people who:

●Had a recent head injury

●Have a bleeding problem

●Have ulcers that are bleeding

●Are pregnant

●Recently had surgery

●Are taking anticoagulant medicines (also called "blood thinners")

●Are injured

●Have very high blood pressure

If a person is having a stroke, the doctor will consider the person's:

●CT scan results – This is an imaging test that can create pictures of the brain. Doctors use it to check for any signs of bleeding in the brain.

●Symptoms – Clot-dissolving medicines might not be given for certain types of stroke. They might also not be used if the person's symptoms are not very severe, or if it has been more than a few hours since the stroke started.

●Other medical conditions

Certain conditions might make clot-dissolving medicines unsafe for a person having a stroke. These could include people who:

●Had another stroke or a serious head injury in the past 3 months

●Are bleeding in the brain, or had brain bleeding in the past

●Have very high blood pressure

●Take anticoagulant medicines (also called "blood thinners"), or have a low platelet count

How are clot-dissolving medicines given? — These medicines are usually given by IV. An IV is a thin tube that goes into a vein.

Depending on the exact medicine being used, the person might get more than 1 dose.

What happens after getting clot-dissolving medicines? — After getting clot-dissolving medicines, the person will stay in the hospital. The doctors and nurses will carefully monitor their condition and symptoms. They will also watch for any problems that could happen because of the medicine.

Once the medicine is given, some people having a stroke might have another procedure called "thrombectomy." This is when doctors use special tools to remove the clot that is blocking an artery in the brain.

What are the risks of taking clot-dissolving medicines? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding – This is the most common risk. Bleeding can be mild or severe. In severe cases, it can cause bleeding in the brain. This can lead to a "hemorrhagic" stroke.

●Swelling of the mouth and tongue – If this happens, doctors and nurses will work to keep the person's airway open.

What else should I know? — Clot-dissolving medicines can be used to treat other problems, too. These include:

●Pulmonary embolism – This is a blood clot in the lung.

●Deep vein thrombosis – This is a blood clot in the leg.

●Clots in a catheter or tube – For example, these can be placed in a vein to give medicines.

More on this topic

Patient education: Heart attack (The Basics)
Patient education: Stroke (The Basics)
Patient education: Intracerebral hemorrhage (The Basics)
Patient education: Pulmonary embolism (blood clot in the lung) (The Basics)
Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)

Patient education: Heart attack (Beyond the Basics)
Patient education: Stroke symptoms and diagnosis (Beyond the Basics)
Patient education: Ischemic stroke treatment (Beyond the Basics)
Patient education: Hemorrhagic stroke treatment (Beyond the Basics)
Patient education: Pulmonary embolism (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)