Ischemic stroke after administration of fibrinolytics in a patient with a ventricular pseudoaneurysm.
We present a case of a 66-year-old man with a preexisting left ventricular pseudoaneurysm as a sequel of an old inferoposterior myocardial infarction. The patient currently presented with respiratory insufficiency and chest pain. Based on his admittance electrocardiogram, he was treated with fibrinolytics for a presumed acute inferior ST-elevation myocardial infarction (in fact, the ST-elevations were the hallmark of the pseudoaneurysm). This treatment caused extensive ischemic stroke, as a consequence of dissolution and embolization of thrombi that were abundantly present in the pseudoaneurysm. The admittance electrocardiogram pointed out to be misleading to the treating physician and led to the unnecessary administration of fibrinolytics with serious complications.
Michiels
Vincent
V
Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium. vincentmichiels@telenet.be
Haine
Steven
S
Vrints
Christiaan
C
D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D019300:Medical Errors; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D005343:Fibrinolytic Agents