Open AccessCardiac Tamponade after Thrombolysis for Acute Ischemic Stroke - A Case with an Excellent Outcome
Author(s) -
Ana Vera-Cruz,
Marta Cerol,
Maria Margarida Pereira,
Sonia Cañadas,
Juliana Mortágua,
Ion Gherbovetchi,
J.P. Andrade
Publication year - 2020
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2020_001534
Subject(s) - medicine , cardiogenic shock , thrombolysis , cardiac tamponade , pericardiocentesis , hemopericardium , complication , myocardial infarction , tamponade , aortic dissection , stroke (engine) , cardiology , surgery , aorta , engineering , mechanical engineering
Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is the established treatment for acute ischemic stroke and has been highly effective in reducing the neurological deficit. Serious adverse events are not uncommon, with hemorrhage being the major complication. We describe the case of a patient with acute ischemic stroke that also presented with vague cardiac symptoms and was treated with rtPA, which was complicated by a hemopericardium causing cardiac tamponade. Pericardiocentesis was promptly performed, which resulted in rapid resolution of the cardiogenic shock. The patient recovered consciousness within a few minutes. A search of the MEDLINE database shows that this is the first report of cardiac tamponade after rtPA thrombolysis occurring in a patient with no history of recent myocardial infarction or aortic dissection.