Hepatic Bleeding and Hemorrhagic Shock Following Thrombolytic Therapy in Patients With Acute Myocardial Infarction

García-Jiménez, Antonio; Mao, M. Castro; Moan, David Freire; Ferreiro, Sandra Otero; Gutiérrez, Manuel Gómez; ̄az, Milagros Marini D; Fernandez, Jose

doi:10.1378/chest.111.6.1787

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…Only two cases have been reported, in which the patients developed hepatic bleeding after thrombolytic treatment. In one case, haemorrhage occurred after administration of r-tPA, and the patient required emergency surgical intervention, unlike our case 3 4…”

Section: Discussionmentioning

confidence: 56%

Hepatic haemorrhage after thrombolytic administration in a patient with myocardial infarction who had a trauma: are we missing something?

Akay

Dikme

2008

Emergency Medicine Journal

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Myocardial infarction (MI) typically presents with chest pain, dyspnoea and pain in the left arm. In some cases, syncope may ensue and the patients can have blunt trauma to the abdomen, chest or head, which may be overlooked by the doctors and the patient, with more concern focusing on infarction alone. Moreover, signs of trauma may not appear until late in the course of hospitalisation. The patient reported on here had abdominal trauma following a syncopic event, resulting from an inferoposterior MI. Administration of thrombolytic treatment led to a hepatic haemorrhage. This life-threatening complication might have been prevented by a bedside ultrasonography performed by an emergency medicine doctor. This effective use of time can be remembered as "time is muscle".

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Section: Discussionmentioning

confidence: 56%

Hepatic haemorrhage after thrombolytic administration in a patient with myocardial infarction who had a trauma: are we missing something?

Akay

Dikme

2008

Emergency Medicine Journal

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“…Jimenez AG et al reported a few rare cases of subcapsular hepatic hematomas following thrombolytic treatment with drugs like streptokinase and recombinant tissue plasminogen activator (r-tPA) [21]. Kenan et al reported the case of an AMI patient, who developed an intraperitoneal hematoma following thrombolytic therapy [22].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous retroperitoneal and intracranial hemorrhage following streptokinase therapy in acute myocardial infarction: An autopsy case report

Ayyappan,

Shekhawat,

Meshram

et al. 2023

Journal of Forensic Sciences

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Bleeding complications following thrombolytic treatment for acute myocardial infarction (AMI) are not infrequent, among which intracranial hemorrhage is commonly reported. In contrast, retroperitoneal hematoma following the administration of thrombolytics is rarely reported in the literature. We are reporting a case of a middle‐aged man, who presented with left‐sided chest pain and was diagnosed with acute coronary syndrome with anterior wall ST elevation AMI. The patient was administered with thrombolytic drugs, including streptokinase and heparin. Percutaneous coronary intervention in the form of Coronary angioplasty with stent insertion was done to the left anterior descending artery, given coronary artery disease. The blood investigations showed elevated activated partial thromboplastin time and prothrombin time. The patient developed vomiting, altered sensorium, and left‐sided weakness, and a non‐contrast computerized tomography brain was done, which showed acute hemorrhage involving the right frontal lobe with intraventricular extension, so the ventricular drain was placed. The patient developed cardiac arrest and died on the third day. On autopsy examination, the brain showed subarachnoid hemorrhage, intraparenchymal hemorrhage over the right frontal lobe, and clotted blood in all the ventricles. A retroperitoneal hematoma of around 1500 cc was seen over the left side of the peritoneal cavity. This case highlights that although intracranial hemorrhage is a known complication after administrating thrombolytic therapy, clinicians should also be aware of the possibility of retroperitoneal hemorrhage. This case emphasizes the value of an autopsy in determining the cause of death in such situations.

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“…Most cases involved patients receiving medications such as tissue plasminogen activator, streptokinase, and intravenous heparin for acute myocardial infarction. 9–12 In these cases, the time it took for development of symptoms and signs of hepatic hemorrhage ranged from 6 hours to 72 hours. Other cases involved intravenous heparin therapy for a pulmonary embolism and prophylactic dose of low-molecular-weight heparin for a total hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Dual Antiplatelet Agent—Induced Spontaneous Liver Hematoma

Darwish

Iqbal

2012

Ann Pharmacother

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Hepatic Bleeding and Hemorrhagic Shock Following Thrombolytic Therapy in Patients With Acute Myocardial Infarction

Cited by 6 publications

References 4 publications

Hepatic haemorrhage after thrombolytic administration in a patient with myocardial infarction who had a trauma: are we missing something?

Hepatic haemorrhage after thrombolytic administration in a patient with myocardial infarction who had a trauma: are we missing something?

Spontaneous retroperitoneal and intracranial hemorrhage following streptokinase therapy in acute myocardial infarction: An autopsy case report

Dual Antiplatelet Agent—Induced Spontaneous Liver Hematoma

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