Myocardial infarction following recombinant tissue plasminogen activator for acute ischemic stroke: a dangerous complication
周志刚1 王瑞兰1
上海交通大学附属第一人民医院急诊危重病科
Until now, the only established therapy for acute ischemic stroke has been intravenous(IV) recombinant tissue-type plasminogen activator(rt-PA). Common Complications of IV thrombolysis with rt-PA for acute ischemic stroke are hemorrhage, arterial re-occlusion, and anaphylaxis. We describe one case of acute MI immediately following IV rt-PA infusion for acute stroke.So, Acute MI immediately following IV tPA for stroke is a rare but serious complication, and the fragmentation and lysis of intracardiac thrombus may be an important factor. Avoiding to cerebral hemorrhage, we suggest use antiplatelets or anticoagulants after the first 24 hours following IV rt-PA for acute ischemic stroke. Besides spontaneous recanalization of infarct-related arteries maybe associated with greater myocardial salvage and better prognosis.
