Cohen N, Zaidenstein R, Blatt A, Sarafian D A, Litinsky I, Modai D
Department of Internal Medicine A, Assaf Harofeh Medical Center, Zerifin, Israel.
Clin Cardiol. 1998 Aug;21(8):599-601. doi: 10.1002/clc.4960210813.
Complete atrioventricular block and syncope sometimes are the presenting signs of acute myocardial infarction. In a presyncopal attempt to assume sitting position, the patient may fall and suffer consequent trauma. Once in hospital, this sequence of events may be overlooked by both the patient and admitting physicians. Moreover, physical examination initially may not be revealing. We report on two such patients who developed massive subcutaneous bleeding following thrombolytic and heparin treatment. We conclude that these patients constitute a specific group with a relatively high risk of trauma and bleeding at the gluteal region following thrombolytic therapy. Special attention must be given to these patients.
完全性房室传导阻滞和晕厥有时是急性心肌梗死的首发症状。在晕厥前试图坐起时，患者可能会摔倒并因此受伤。一旦住院，患者和收治医生可能都会忽略这一系列事件。此外，最初的体格检查可能并无异常发现。我们报告了两名此类患者，他们在接受溶栓和肝素治疗后出现了大量皮下出血。我们得出结论，这些患者构成了一个特殊群体，在溶栓治疗后臀部区域有相对较高的创伤和出血风险。必须对这些患者给予特别关注。
