[Spleen rupture and ischemic cerebral stroke in a patient with recent myocardial infarction].

A case is presented of recent anterior myocardial infarction in 40-year-old man, treated in acute stage with streptokinase and heparin, complicated by spleen rupture and splenectomy on the 6th day of infarction and by ischemic cerebral stroke on the 15th day. After 10-weeks of therapy patient left the hospital in good clinical condition, which continued 6 months of out-patient follow-up. Results of our examinations excluded haematologic proliferative diseases as a cause of spleen rupture. Fever and recurring pains in the left hypochondrium occurring before infarction suggested possibility of infectious diseases with spleen involvement. In histopathological examination the spleen swelling (as a reaction on an infection) was found. The influence of fibrinolytic and anticoagulant therapy on spleen rupture was discussed. In pathogenesis of ischemic stroke, the thrombocythemia observed after splenectomy and platelet hyperactivity following thrombolytic therapy were taken into consideration.