Key result
Treatment with streptokinase in a patient with aortic dissection and myocardial infarction resulted in transient signs of reperfusion before fatal hypotension and ST segment elevation.
Case Report (n=1)
Clinical and electrocardiographic signs of reperfusion after thrombolysis can occur in patients with aortic dissection, potentially masking the true diagnosis.
Reperfusion signs after thrombolysis may mask aortic dissection in MI; this case report leaves open the need for pre-treatment imaging confirmation.
A 55-year-old man was admitted to the hospital with chest pain and electrocardiogram consistent with the diagnosis of evolving myocardial infarction. Treatment with streptokinase was administered, resulting in clinical and electrocardiographic signs of reperfusion. Hypotension and ST segment elevation occurred 2 hours later and cardiac catheterization was done. At catheterization the diagnosis of aortic dissection was made, but the patient died before surgery. Thus, clinical and electrocardiographic signs of reperfusion after streptokinase may occur in patients with aortic dissection and myocardial infarction.
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Safi et al. (1996) conducted a case report in Acute aortic dissection and myocardial infarction (n=1). Streptokinase was evaluated on Clinical and electrocardiographic signs of reperfusion and survival. Treatment with streptokinase in a patient with aortic dissection and myocardial infarction resulted in transient signs of reperfusion before fatal hypotension and ST segment elevation.