Massive hemorrhagic myocardial infarction after coronary thrombolysis |
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| Authors: | E J Topol A Herskowitz G M Hutchins |
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| Affiliation: | 1. Institute of Clinical Pharmacology, the Second Affiliated Hospital of Harbin Medical University (The University Key Laboratory of Drug Research, Heilongjiang Province), Harbin 150086, PR China;2. State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, PR China;3. Department of Clinical Pharmacology, College of Pharmacy, Harbin Medical University, Harbin 150081, PR China |
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| Abstract: | A 53-year-old man with occlusion of the proximal left anterior descending coronary artery received intravenous tissue plasminogen activator, and reperfusion was achieved within four and a half hours from the onset of chest pain. Recurrence of electrocardiographic ST segment elevation without attendant chest pain heralded reocclusion in the first hour after thrombolysis, which was successfully treated. After a stable course, post-infarction refractory cardiogenic shock developed on day 4, and autopsy demonstrated a massive (more than 100 cm2) hemorrhagic infarct. Several features of this case underscore the potential of coronary thrombolysis to cause significant reperfusion injury. |
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