Cheung P K, Arnold J M, McLarty T D
Department of Medicine, Victoria Hospital, University of Western Ontario, London.
Can J Cardiol. 1990 Jun;6(5):183-5.
Thrombolytic therapy with tissue plasminogen activator (tPA) for acute myocardial infarction may result in major bleeding complications such as gastrointestinal or intracranial bleeding. A case is described of severe splenic hemorrhage and rupture which developed 3 h after completion of tPA infusion for suspected acute myocardial infarction. The patient developed hypovolemic shock with abdominal pain and distension and further evidence of myocardial necrosis. A computed tomography scan of the abdomen was helpful in elucidating the diagnosis, and surgical splenectomy resulted in a good patient outcome, though the period of hypotension had increased the extent of myocardial necrosis.
