These are also known as thrombolytic agents. They are given intravenously in the hospital to rapidly dissolve blood clots. They are used to:

• Dissolve blood clots in the arteries of the heart that cause heart attacks (myocardial infarction). This minimizes damage to the heart muscle and markedly improves the survival of an acute heart attack victim. They are most beneficial when given early. That is why it is important for patients to get to the hospital immediately if they think they might be having a heart attack.
• Dissolve blood clots in leg veins (phlebitis). This rapidly diminishes the symptoms and may lessen the long term damage to the veins.
• Disslove blood clots in the arteries of the lungs (pulmonary embolus). This helps improve survival and minimize the damage to the lungs and cardiovascular system.
• Disslove blood clots in the brain that cause strokes. Time is of the essence here also. It must be given within 3 hours of the onset of the stroke.
• Dissolve blood clots that form within indwelling intravenous catheters. This can obviate the need to place a new catheter.
• Dissolve blood clots that clog artificial heart valves. This may avoid the need for emergency open heart surgery for this potentially life threatening condition.

The main risk with these agents is excessive bleeding.

There is some controversy among cardiologists whether an acute heart attack victim should be treated with an emergency angioplasty rather than a thrombolytic agent. There does appear to be some advantages to the emergency angioplasty but logistical problems involved in getting the angioplasty team assembled in time sometimes makes the thrombolytic agent a better option. In addition, not all hospitals have the facilities to perform angioplasty.

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