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

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 fibrino...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of emergency medicine 2009-11, Vol.27 (9), p.1176.e5-1176.e7
Main Authors: Michiels, Vincent, MD, Haine, Steven, MD, Vrints, Christiaan, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Aneurysm, False - complications
Aneurysm, False - diagnosis
Aneurysm, False - therapy
Blood
Brain Ischemia - diagnosis
Brain Ischemia - etiology
Brain Ischemia - therapy
Coronary Aneurysm - complications
Coronary Aneurysm - diagnosis
Coronary Aneurysm - therapy
Coronary vessels
Electrocardiography
Embolization
Emergency
Emergency medical care
Enzymes
Fibrinolytic Agents - adverse effects
Heart attacks
Heart Ventricles
Humans
Ischemia
Male
Medical Errors
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - drug therapy
Patients
Pericardium
Pseudoaneurysm
Respiratory failure
Stroke
Stroke - diagnosis
Stroke - etiology
Stroke - therapy
Tomography
Veins & arteries
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2009.02.017