Cocaine-associated myocardial infarction. A word of caution about thrombolytic therapy

The recent approval of tissue plasminogen activator (tPA) by the Food and Drug Administration has opened a new era in the management of acute coronary occlusions. Absolute contraindications are well established. A case of intracranial bleeding as a complication of thrombolytic therapy in an intravenous substance abuser is presented. This may represent a relative contraindication to thrombolytic therapy.