“Stroke and Heparin?”
If a patient is admitted for stroke and the reason for the stroke is unknown, should Heparin be given before knowing if the stroke was caused by a blood clot or bleeding? If it's given and it turns out that the stroke was caused by bleeding, wouldn't it negatively impact the patient?
2 Answers
CardiologistCardiologist
A scan is performed before medication is given to find out if there is a clot or if there is bleeding present. There are also other physical signs if a patient is having a bleed.
Mark Rasak
Cardiologist
Typically, if the patient presents early under (6 hrs) and there is no contraindication, the patient will undergo thrombolysis. The window was widened with the latest guideline updates to 24 hrs. It's determined on a case by case basis. Heparin is NOT typically indicated routine. Indications would be it the patient comes in with a-fib or echo shows obvious cardiac source either by surface echo or by TEE. Otherwise, symptomatic vascular dissection would also be an indication. The call for heparin would be on the table if hypercoagulable panel came back positive as well.
