Medical Q&As

Stroke - dissolving the clot?

I am 56 years old and live in the USA. I recently had a stroke for which I was given TPA to dissolve the clot. It was miraculous. I am now on Plavix daily to thin my blood. It seems from tests since then that my sinoatrial node is not functioning properly and that I will probably need a pacemaker. My questions are: (1) Is TPA readily available in hospitals in Ireland? (2) Is Plavix used in Ireland? (3) I have been under a huge amount of stress and depression for the past 9 months. Do you think this could have caused the problem in my sinoatrial node? If so, would getting out of the stress correct the problem or do I need a pacemaker?

TPA stands for tissue plasminogen activator, which is an enzyme that dissolves clots. It is available in Irish hospitals as are other drugs that are colloquially referred to as “clot busters”. Plavix, which is the second drug you enquired about, is also available in Ireland on prescription. With regard to the third part of your question I don’t think that stress management will obviate the need for a pacemaker. The sinoatrial node you refer to is the heart’s own pacemaker. The sinoatrial node discharges electrical impulses through the electrical conducting system of the heart thereby regulating the rate and rhythm of the heartbeat. If it becomes defective and discharges chaotically its function needs to be over-ridden with an artificial pacemaker.