Fibrinolysis in cardiac arrest

Cardiac arrest is a classic contraindication for fibrinolysis, due to possible hemorrhagic complications. Most cardiac arrests, particularly those occurring out-of-hospital, are caused by vascular thrombosis, including myocardial infarction and pulmonary embolism, in which fibrinolysis has proved to be an effective treatment. Indeed, there are several reports and clinical trials suggesting that fibrinolysis may be a safe and effective therapeutic option in patients with cardiac arrest of presumed cardiovascular cause. Based on a case of successful fibrinolytic treatment of a pulmonary embolism patient with cardiac arrest, these questions are reviewed.