Streptokinase Lysis of Intraventricular Thrombus and Pulmonary Emboli with Resolution of Acquired Intracardiac Shunt

thromboembol ic disorders. In the case reported here, in-travenous infusion of streptokinase el iminated right-to-left intracardiac shunting in a patient with acute pulmo-nary embol ism. This treatment s imultaneously lysed a left ventricular thrombus. T h e shunting site and throm-bolysis were shown echocardiographically. A 94-year-old man was hospitalized with acute dyspnea and left arm paralysis. His history included a myocardial infarction but no neurologic disease. Physical findings included a tempera-ture of 36.8 °C; pulse, 75 beats/min; blood pressure, 90/50 mm Hg; central cyanosis, tachypnea, and jugular venous distension. Heart sounds were normal and lungs were clear. His left arm was cold, pulseless, and deeply cyanotic. A chest roentgeno-gram showed an enlarged heart shadow and clear lungs. An electrocardiogram showed normal sinus rhythm and evidence