title: Use of thrombolytic therapy to treat heparin-refractory pulmonary embolism in a menstruating patient.
abstract: A 26-year-old woman developed an acute pulmonary embolism at the beginning of her menstrual cycle and was admitted to the hospital. When she failed initial standard treatment with heparin, the only other therapeutic option was a thrombolytic agent such as recombinant tissue plasma activator (rt-PA). Use of these agents, however, carries a large risk of major bleeding complications and brings concern of increased menstrual blood flow and duration. A literature search of the use of thrombolytic agents in menstruating patients found only limited reports. Our patient responded well to rt-PA therapy Her hemoglobin levels remained stable, and she experienced no bleeding complications. Careful monitoring and caution are recommended when administering thrombolytic agents to menstruating patients.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Illinois 60612, USA.
authors.forename: Ada Z
authors.initials: AZ
authors.lastname: Koch
authors.forename: Jawed
authors.initials: J
authors.lastname: Abubaker
authors.forename: V Theodore
authors.initials: VT
authors.lastname: Barnett
authors.forename: Lingtak-Neander
authors.initials: LN
authors.lastname: Chan
mesh_terms: D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008598:Menstruation / Q000502:physiology*; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D006493:Heparin; D010959:Tissue Plasminogen Activator