Sabine Fitzek1, Clemens Fitzek. 1. Departments of *Neurology †Radiology and Neuroradiology, Asklepios Fachklinikum Brandenburg, Brandenburg, Germany.
Abstract
INTRODUCTION: There are reports of an ischemic stroke during intravenous recombinant tissue-type plasminogen activator (rtPA) for evolving myocardial infarction (MI), and the risk of stroke shortly after an acute MI seems to be higher than in the control population, attributed to intracardiac thrombus formation. CASE REPORT: We report a case of fatal MI developing immediately after the start of rtPA infusion for middle cerebral artery stroke in an 88-year-old woman. We assume that the systemic thrombolysis with rtPA led to the fragmentation of an underlying cardiac thrombus, which embolized and occluded the coronary artery and caused MI. This hypothesis is discussed with respect to a short review of the related literature. CONCLUSIONS: An embolic MI seems to be a rare but serious complication in thrombolysis therapy with rtPA.
INTRODUCTION: There are reports of an ischemic stroke during intravenous recombinant tissue-type plasminogen activator (rtPA) for evolving myocardial infarction (MI), and the risk of stroke shortly after an acute MI seems to be higher than in the control population, attributed to intracardiac thrombus formation. CASE REPORT: We report a case of fatal MI developing immediately after the start of rtPA infusion for middle cerebral artery stroke in an 88-year-old woman. We assume that the systemic thrombolysis with rtPA led to the fragmentation of an underlying cardiac thrombus, which embolized and occluded the coronary artery and caused MI. This hypothesis is discussed with respect to a short review of the related literature. CONCLUSIONS: An embolic MI seems to be a rare but serious complication in thrombolysis therapy with rtPA.
Authors: Ton Mai Duy; Phuong DaoViet; Dung Nguyen Tien; Quang-Anh Nguyen; Thien Nguyen Tat; Viet Anh Hoang; Trung Le Hong; Huy Nguyen Van; Dat Anh Nguyen; Chi Nguyen Van; Nguyen Vu Thai Lien; Vu Thi Nga; Dinh-Toi Chu Journal: J Int Med Res Date: 2019-08-15 Impact factor: 1.671