title: An unusual case of hypotension after fibrinolysis resulting from mediastinal hemorrhage.
abstract: BACKGROUND
  Although bleeding complications may occur after fibrinolysis, mediastinal hemorrhage is extremely rare.
  
  
  METHODS
  We encountered mediastinal hemorrhage in a case of anterior wall myocardial infarction (MI); the patient developed sudden-onset chest pain with hypotension after fibrinolysis. The differential diagnosis and approach to management of such a case is discussed.
  
  
  CONCLUSIONS
  As fibrinolysis remains a common means of establishing reperfusion in patients with acute MI, emergency physicians should be aware of such unusual complications secondary to fibrinolysis. An orderly clinical approach with an individualized management protocol is essential in such situations so that undue instrumentation and invasive procedures with their attendant risks in a thrombolysed patient are avoided.
authors: Department of Cardiology, Jaswant Rai Specialty Hospital, Meerut, India.
authors: Rajeev
authors: R
authors: Agarwala
authors: Aditya
authors: A
authors: Kapoor
mesh_terms: D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy
chemical_list: D005343:Fibrinolytic Agents