Embolic cerebral infarction and gastrointestinal hemorrhage following thrombolytic therapy for acute myocardial infarction.
We report an unusual case of cerebral embolization that occurred after intravenous thrombolytic therapy for myocardial infarction. Direct observation by serial echocardiograms in this patient confirmed that the thrombolytic treatment induced lysis and fragmentation of thrombus, and the subsequent dislodging and embolization of preexisting cardiac thrombi, which caused the cerebral infarction. It is suggested that an echocardiogram, if instantly available, be performed before considering thrombolytic therapy whenever acute anterior wall myocardial infarction is impressed.
Chang
Michael Chich-kuang
MC
Division of Cardiology, Jen Ai Hospital, Tali, Taichung, Taiwan, Republic of China.
Lee
Andrew Ying-siu
AY
Chang
Wen-fung
WF
Chen
Tien-jen
TJ
D000368:Aged; D004452:Echocardiography; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*; D017211:Treatment Failure
D010959:Tissue Plasminogen Activator