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Date: 10 Aug 2010
Cardiac Rupture After Intravenous t-PA Administration in Acute Ischemic Stroke
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Ventricular free wall rupture is a fatal complication of myocardial infarction (MI). Although described in MI patients who receive thrombolytic therapy, this complication is not well known in ischemic stroke patients who receive intravenous (IV) t-PA.
We present a 93-year-old woman with an acute onset of a right middle cerebral artery syndrome in the setting of subacute MI. IV t-PA was administered and she subsequently developed asystolic arrest and died. Autopsy showed subacute MI, hemopericardium, and rupture of the left ventricle.
This case illustrates a fatal cardiac complication of IV thrombolytic therapy for stroke. The speculated mechanism is hemorrhage into the infarcted myocardium.
Pislaru SV, Barrios L, Stassen T, Jun L, Pislaru C, Van de Werf F. Infarct size, myocardial hemorrhage, and recovery of function after mechanical versus pharmacological reperfusion: effects of lytic state and occlusion time. Circulation. 1997;96:659–66.PubMed
Adams HP Jr, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655–711.CrossRefPubMed
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- Cardiac Rupture After Intravenous t-PA Administration in Acute Ischemic Stroke
Volume 13, Issue 2 , pp 261-262
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press Inc
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- Ischemic stroke
- Myocardial infarction
- IV t-PA
- Cardiac rupture
- Industry Sectors
- Author Affiliations
- 1. Department of Neurology, University of California San Francisco, 505 Parnassus Avenue, Box 0114, San Francisco, CA, 94143-0114, USA
- 2. Neuropathology Unit, University of California San Francisco, San Francisco, CA, USA