title: Spontaneous psoas hematoma in a case of acute myocardial infarction following streptokinase infusion.
abstract: BACKGROUND
  Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases.
  A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads. Patient was diagnosed with Acute STEMI and thrombolysis was initiated with STK. The following day, the patient complained of pain in his left groin. On examination, there was a swelling and tenderness in left lower abdomen and inability to extend the hip. A CT scan was done, which showed Psoas muscle hematoma.
  
  
  CONCLUSIONS
  Spontaneous bleed into psoas muscle is a very rare complication of thrombolysis that may require surgical exploration.
authors.affiliation: Senior Resident in Cardiology, Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, India. Electronic address: sunil167@yahoo.com.
authors.forename: B Sunil
authors.initials: BS
authors.lastname: Abhishek
authors.affiliation: Associate Professor in Cardiology, Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, India.
authors.forename: Sai C
authors.initials: SC
authors.lastname: Vijay
authors.affiliation: Associate Professor in Cardiology, Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, India.
authors.forename: V
authors.initials: V
authors.lastname: Avanthi
authors.affiliation: Professor and Head of Department, Department of Cardiology, Vydehi Institute of Medical Sciences and Research Center, Whitefield, Bangalore, India.
authors.forename: B
authors.initials: B
authors.lastname: Kumar
mesh_terms: D004562:Electrocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016658:Psoas Muscles; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D013300:Streptokinase / Q000008:administration & dosage / Q000009:adverse effects*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D013300:Streptokinase
keywords: Acute myocardial infarction; Hematoma; Psoas; Spontaneous; Streptokinase