title: Rescue thrombolysis in the treatment of cardiac shock and acute stroke.
abstract: The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ventricular ST-elevation myocardial infarction. He was found to have occlusion of both right coronary artery and left anterior descending artery and managed with rescue thrombolysis. It was subsequently recognized that he had concurrent stroke caused by posterior cerebral artery (PCA) occlusion and improved with thrombolysis. It is reported for the first time that rescue thrombolysis has been put into practice and yielded great result after unsuccessful primary PCI.
authors.affiliation: Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey. sukruakyuz@hotmail.com
authors.forename: Sukru
authors.initials: S
authors.lastname: Akyuz
authors.forename: Mustafa Azmi
authors.initials: MA
authors.lastname: Sungur
authors.forename: Cevdet
authors.initials: C
authors.lastname: Donmez
authors.forename: Aylin
authors.initials: A
authors.lastname: Sungur
authors.forename: Nese
authors.initials: N
authors.lastname: Cam
mesh_terms: D000328:Adult; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020762:Infarction, Posterior Cerebral Artery / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D062645:Percutaneous Coronary Intervention; D016879:Salvage Therapy; D012770:Shock, Cardiogenic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator