title: Acute myocardial infarction during streptokinase therapy.
abstract: A 45-year-old man developed sequential inferolateral and anterior myocardial infarctions within 10 hours of a possible allergic reaction to oral penicillin. The anterior myocardial infarction occurred during apparently successful streptokinase therapy for the initial inferolateral infarction. Subsequent coronary arteriography confirmed a subtotal stenosis of the left circumflex coronary artery and a complete thrombotic occlusion of the left anterior descending artery. This case documents the occurrence of three rare clinical phenomena; first, the occurrence of sequential acute myocardial infarctions in close temporal proximity; second, the occurrence of myocardial infarction during thrombolytic therapy; and third, the association of myocardial infarction with a possible allergic reaction.
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000188:drug therapy / Q000209:etiology; D010406:Penicillins / Q000009:adverse effects*; D013300:Streptokinase / Q000627:therapeutic use*
chemical_list: D010406:Penicillins; D013300:Streptokinase