title: Interventionalists beware: the apical thrombus!
abstract: Recent myocardial infarction is a recognized risk factor for ischemic stroke. Patients who have a stroke in the peri-infarct period are usually in hospital and therefore well placed to access early cerebral reperfusion therapy. However, due to the risk of myocardial rupture, recent myocardial infarction is considered a contraindication to intravenous thrombolysis, which is usually the first-line therapy for the treatment of ischemic stroke. We report a case in which intravenous thrombolysis was safely and effectively used to treat acute ischemic stroke in a patient who had suffered an acute myocardial infarct within the previous 48 h. We also highlight the lack of evidence-based guidelines for the treatment of stroke in this important subgroup of patients.
authors: Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia. sinjini.biswas@mh.org.au
authors: Sinjini
authors: S
authors: Biswas
authors: Andrew E
authors: AE
authors: Ajani
mesh_terms: D000208:Acute Disease; D017023:Coronary Angiography / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D015912:Thrombolytic Therapy / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents