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. 2020 Mar 13;7(4):001534.
doi: 10.12890/2020_001534. eCollection 2020.

Cardiac Tamponade after Thrombolysis for Acute Ischemic Stroke A Case with an Excellent Outcome

Ana Vera-Cruz  1 , Marta Cerol  1 , Maria Margarida Pereira  1 , Sónia Canadas  2 , Juliana Mortágua  3 , Ion Gherbovetchi  3 , José Pedro Andrade  3
Affiliations

Cardiac Tamponade after Thrombolysis for Acute Ischemic Stroke A Case with an Excellent Outcome

Ana Vera-Cruz et al. Eur J Case Rep Intern Med. .

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.

Learning points: Cardiac tamponade is a medical emergency and if not recognized and treated quickly results in cardiogenic shock and death. Hence, it is necessary to be aware that the established treatment for acute ischemic stroke can lead to cardiac tamponade.Cardiac tamponade after rtPA thrombolysis can occur in patients with no history of recent myocardial infarction or aortic dissection.

Keywords: Acute ischemic stroke; cardiac tamponade; hemopericardium; thrombolysis; tissue plasminogen activator.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

References

    1. Jensen JK, Poulsen SH, Mølgaard H. Cardiac tamponade: a clinical challenge. E J Cardiol Pract. 2017;15(17):107–113.
    1. 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. - PubMed
    1. 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. - PubMed
    1. Ching S, Ting SM. When stroke is more than stroke. Am J Emerg Med. 2016;34(6):1189.e1–1189.e2. - PubMed

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