Cardiac Tamponade after Thrombolysis for Acute Ischemic Stroke - A Case with an Excellent Outcome
  • Ana Vera-Cruz
    Medicine Department, Internal Medicine Service, District Hospital of Santarém, Santarém, Portugal http://orcid.org/0000-0002-2217-9350
  • Marta Cerol
    Medicine Department, Internal Medicine Service, District Hospital of Santarém, Santarém, Portugal http://orcid.org/0000-0002-0732-7204
  • Maria Margarida Pereira
    Medicine Department, Internal Medicine Service, District Hospital of Santarém, Santarém, Portugal
  • Sónia Canadas
    Medicine Department, Internal Medicine Service, Hospital Sousa Martins, Guarda, Portuga http://orcid.org/0000-0001-8584-3661
  • Juliana Mortágua
    Emergency Department, Intermediate Care Unit, District Hospital of Santarém, Santarém, Portugal
  • Ion Gherbovetchi
    Emergency Department, Intermediate Care Unit, District Hospital of Santarém, Santarém, Portugal
  • José Pedro Andrade
    Emergency Department, Intermediate Care Unit, District Hospital of Santarém, Santarém, Portugal

Keywords

Acute ischemic stroke, tissue plasminogen activator, thrombolysis, hemopericardium, cardiac tamponade

Abstract

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.

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References

  • Jensen JK, Poulsen SH, Mølgaard H. Cardiac tamponade: a clinical challenge. E J Cardiol Pract 2017;15(17):107–113.

  • Hensen H, Spaander F, Bax M, Koppen H. Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischemic stroke. Am J Emerg Med 2016;34(12):2462.e5-2462.e6.

  • DeSilva DA, Manzano JJ, Chang HM, Wong MC. Reconsidering recent myocardial infarction as a contraindication for IV stroke thrombolysis. Neurology 2011;76(21):1838–1840.

  • Ching S, Ting SM. When stroke is more than stroke. Am J Emerg Med 2016;34(6):1189.e1-1189.e2.

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    Published: 2020-03-13
    Issue: 2020: Vol 7 No 4 (view)

    How to cite:
    1.
    Vera-Cruz A, Cerol M, Pereira MM, Canadas S, Mortágua J, Gherbovetchi I, Andrade JP. Cardiac Tamponade after Thrombolysis for Acute Ischemic Stroke - A Case with an Excellent Outcome. EJCRIM 2020;7 doi:10.12890/2020_001534.

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