Which condition is considered a relative contraindication for fibrinolytics in a patient with STEMI?

In the context of fibrinolytic therapy for patients with ST-Elevation Myocardial Infarction (STEMI), certain conditions are considered relative contraindications—that is, situations where the risks must be weighed against the benefits. Among the options, pregnancy is identified as a relative contraindication for the use of fibrinolytics.

During pregnancy, the physiological changes and increased risk of bleeding complications can pose significant challenges. Fibrinolytics can disrupt the delicate balance needed to sustain pregnancy and can pose risks to both the mother and fetus, including potential hemorrhage. Therefore, while not an absolute contraindication, the use of fibrinolytics during pregnancy warrants careful consideration and an assessment of individual risk factors.

In contrast, prior intracranial hemorrhage, active internal bleeding, and a known allergy to the fibrinolytic agent are generally seen as absolute contraindications. These conditions carry a clear and significant risk of severe complications that would likely prompt a complete avoidance of fibrinolytic therapy.