Tissue plasminogen activator (t-PA) is considered for the treatment of a patient who arrives in the emergency department following the onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA?
A. Worsening chest pain that began earlier in the evening
B. History of cerebral hemorrhage
C. History of prior myocardial infarction
D. Hypertension
Correct Answer: B. History of cerebral hemorrhage
A history of cerebral hemorrhage is a contraindication to tPA because it may increase the risk of bleeding. TPA acts by dissolving the clot blocking the coronary artery and works best when administered within 6 hours of onset of symptoms.
Option A: Chest pain is one of the symptoms of myocardial infarction.
Option C: Prior MI is not a contraindication to tPA.
Option D: Patients receiving tPA should be observed for changes in blood pressure, as tPA may cause hypotension.