[Thrombolytic treatment for acute myocardial infarction in menstruating women].

A 44-year-old woman was admitted to the intensive cardiac care unit due to an extensive anterior myocardial infarction of acute onset. Because she was menstruating, thrombolytic treatment was relatively contraindicated. On primary coronary angioplasty, an occluding clot was found in her proximal, left anterior coronary artery. Despite menstrual bleeding, 500,000 IU/10 min of urokinase was infused into the artery. After restoration of blood flow, angioplasty was performed and a 90% residual stenosis was found in the artery. She was then fully heparinized for 5 days and concomitantly given aspirin, 100 mg/day. There were no complications, nor was menstrual bleeding excessive. She was discharged in good clinical and hemodynamic status after 10 days of hospitalization. Based on our experience, and reinforced by an additional 23 cases reported by others, we suggest that thrombolytic treatment should not be withheld even in menstruating women, when access to primary, coronary angioplasty is not available.