Cardiac catheterization with thrombolysis, anticoagulation and/or use of antiplatelet agents may be associated with bleeding as a complication.


TIMI (Thrombolysis in Myocardial Infarction) classification:

(1) major bleeding

(2) minor bleeding


Bleeding Manifestation


drop in hemoglobin > 5 g/dL


intracranial hemorrhage (stroke)


drop in hemoglobin from 3-5 g/dL with known bleeding site


drop in hemoglobin < 3 g/dL with gross hematuria, hematemesis, and/or hemoptysis




• The interpretation gets difficult if the person has bleeding at other sites unrelated to the cardiac catheterization..

• A drop in hemoglobin > 5 g/dL is approximately equivalent to a drop in the hematocrit > 15 percent.


Additional bleeding criteria:

(1) hematoma at arteriotomy site (definition varies with study. as shown in Table 3 in Resnice et al; Exaire et al used > 5 cm)

(2) significant rebleeding after initial hemostasis

(3) bleeding associated with a delay in hospital discharge

(4) bleeding requiring transfusion

(5) retroperitoneal hematoma


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