Which of the following patients is the BEST candidate for fibrinolytic therapy?

The best candidate for fibrinolytic therapy among the presented options is the 50-year-old man who has slurred speech and left arm weakness that started 45 minutes ago. Fibrinolytic therapy is typically indicated for patients with acute ischemic stroke, especially when treatment is initiated within the therapeutic window, which is usually within three to four and a half hours of symptom onset.

In this case, the man's symptoms of slurred speech and left arm weakness are suggestive of an acute stroke, possibly due to a thrombotic event, which fibrinolytics are designed to address by dissolving the blood clot that is obstructing blood flow to the brain. The time frame of 45 minutes is critical; it falls well within the ideal treatment window for fibrinolytic therapy, maximizing the chance for recovery and minimal long-term disability.

In contrast, the other options present patients at high risk for complications or those with contraindications for fibrinolytic therapy. For instance, the woman who experienced a severe headache and is now unresponsive likely suffered a hemorrhagic stroke, which is a major contraindication for fibrinolytics as it could worsen bleeding. The man with declining mental status over 12 hours may be experiencing a stroke, but the time elapsed