Ischemic stroke after administration of fibrinolytics in a patient with a ventricular pseudoaneurysm

The American Journal of Emergency Medicine
Vincent MichielsChristiaan Vrints

Abstract

We present a case of a 66-year-old man with a preexisting left ventricular pseudoaneurysm as a sequel of an old inferoposterior myocardial infarction. The patient currently presented with respiratory insufficiency and chest pain. Based on his admittance electrocardiogram, he was treated with fibrinolytics for a presumed acute inferior ST-elevation myocardial infarction (in fact, the ST-elevations were the hallmark of the pseudoaneurysm). This treatment caused extensive ischemic stroke, as a consequence of dissolution and embolization of thrombi that were abundantly present in the pseudoaneurysm. The admittance electrocardiogram pointed out to be misleading to the treating physician and led to the unnecessary administration of fibrinolytics with serious complications.

References

Oct 23, 1981·JAMA : the Journal of the American Medical Association·A H DachmanN Solomon
Oct 23, 1997·Clinical Cardiology·K CsapoD J Kereiakes
Feb 21, 1998·Annals of Internal Medicine·T C YeoJ B Seward

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