With current clinical strategies for managing acute myocardial infarction, red blood cell transfusions are required to treat approximately 0.6 % to 4.0 % of patients who receive thrombolytic therapy and suffer hemorrhagic complications. The actual risk of serious subsequent morbidity (e.g., AIDS or chronic hepatitis) associated with such transfusions is small, occurring in only 0.018% to 0.12 % of patients who receive thrombolytic therapy. Despite a small actual risk of transfusion-related morbidity, patients may perceive the risk associated with transfusions to be substantial. Accordingly physicians have an obligation to assuage patients' fears regarding transfusions during the process of obtaining informed consent for treatment with thrombolytic therapy. The clinical setting of acute myocardial infarction, however, makes it difficult to obtain truly informed consent that includes the risks of receiving a transfusion, as well as the risk of transfusion-related morbidity. Given this difficulty, several suggestions for physicians to enhance patient involvement in medical decision making for thrombolytic therapy are provided.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine