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Cardiac Rupture After Intravenous t-PA Administration in Acute Ischemic Stroke

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Abstract

Background

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.

Methods

Case report.

Results

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.

Conclusions

This case illustrates a fatal cardiac complication of IV thrombolytic therapy for stroke. The speculated mechanism is hemorrhage into the infarcted myocardium.

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References

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Author information

Authors and Affiliations

  1. Department of Neurology, University of California San Francisco, 505 Parnassus Avenue, Box 0114, San Francisco, CA, 94143-0114, USA

    Amar Dhand, Kazuma Nakagawa, Seema Nagpal, Jeffrey M. Gelfand, Anthony S. Kim & Wade S. Smith

  2. Neuropathology Unit, University of California San Francisco, San Francisco, CA, USA

    Tarik Tihan

Authors
  1. Amar Dhand
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  2. Kazuma Nakagawa
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  3. Seema Nagpal
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  4. Jeffrey M. Gelfand
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  5. Anthony S. Kim
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  6. Wade S. Smith
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  7. Tarik Tihan
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Corresponding author

Correspondence to Amar Dhand.

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Dhand, A., Nakagawa, K., Nagpal, S. et al. Cardiac Rupture After Intravenous t-PA Administration in Acute Ischemic Stroke. Neurocrit Care 13, 261–262 (2010). https://doi.org/10.1007/s12028-010-9384-8

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  • DOI: https://doi.org/10.1007/s12028-010-9384-8

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