title: A Myocardial Infarction During Intravenous Recombinant Tissue Plasminogen Activator Infusion for Evolving Ischemic Stroke.
abstract: BACKGROUND
  There are reports of an ischemic stroke during intravenous recombinant tissue-type plasminogen activator (rtPA) for evolving myocardial infarction (MI), and the risk of stroke shortly after an acute MI seems to be higher than in the control population, attributed to intracardiac thrombus formation.
  
  
  METHODS
  We report a case of fatal MI developing immediately after the start of rtPA infusion for middle cerebral artery stroke in an 88-year-old woman. We assume that the systemic thrombolysis with rtPA led to the fragmentation of an underlying cardiac thrombus, which embolized and occluded the coronary artery and caused MI. This hypothesis is discussed with respect to a short review of the related literature.
  
  
  CONCLUSIONS
  An embolic MI seems to be a rare but serious complication in thrombolysis therapy with rtPA.
authors.affiliation: Departments of *Neurology †Radiology and Neuroradiology, Asklepios Fachklinikum Brandenburg, Brandenburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Fitzek
authors.forename: Clemens
authors.initials: C
authors.lastname: Fitzek
mesh_terms: D061605:Administration, Intravenous; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000209:etiology / Q000517:prevention & control*; D009203:Myocardial Infarction / Q000150:complications*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator