静脉注射 t-PA 后急性缺血性脑卒中并发心脏破裂。
Cardiac rupture after intravenous t-PA administration in acute ischemic stroke.
机构信息
Department of Neurology, University of California San Francisco, 505 Parnassus Avenue, Box 0114, San Francisco, CA 94143-0114, USA.
出版信息
Neurocrit Care. 2010 Oct;13(2):261-2. doi: 10.1007/s12028-010-9384-8.
BACKGROUND
Ventricular free wall rupture is a fatal complication of myocardial infarction (MI). Although described in MI patients who receive thrombolytic therapy, this complication is not well known in ischemic stroke patients who receive intravenous (IV) t-PA.
METHODS
Case report.
RESULTS
We present a 93-year-old woman with an acute onset of a right middle cerebral artery syndrome in the setting of subacute MI. IV t-PA was administered and she subsequently developed asystolic arrest and died. Autopsy showed subacute MI, hemopericardium, and rupture of the left ventricle.
CONCLUSIONS
This case illustrates a fatal cardiac complication of IV thrombolytic therapy for stroke. The speculated mechanism is hemorrhage into the infarcted myocardium.
背景
心室游离壁破裂是心肌梗死（MI）的一种致命并发症。尽管在接受溶栓治疗的 MI 患者中已有描述，但在接受静脉（IV）t-PA 的缺血性卒中患者中，这种并发症并不为人所知。
方法
病例报告。
结果
我们报告了一例 93 岁女性，在亚急性 MI 背景下急性出现右侧大脑中动脉综合征。给予 IV t-PA 后，她随后出现心脏停搏并死亡。尸检显示亚急性 MI、血心包和左心室破裂。
结论
本例说明了 IV 溶栓治疗卒中的致命心脏并发症。推测的机制是出血进入梗死的心肌。
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