• J Emerg Med · Jan 2013

    Case Reports

    An unusual case of hypotension after fibrinolysis resulting from mediastinal hemorrhage.

    • Rajeev Agarwala.
    • Department of Cardiology, Jaswant Rai Specialty Hospital, Meerut, India.
    • J Emerg Med. 2013 Jan 1;44(1):e49-51.

    BackgroundAlthough bleeding complications may occur after fibrinolysis, mediastinal hemorrhage is extremely rare.Case ReportWe encountered mediastinal hemorrhage in a case of anterior wall myocardial infarction (MI); the patient developed sudden-onset chest pain with hypotension after fibrinolysis. The differential diagnosis and approach to management of such a case is discussed.ConclusionAs fibrinolysis remains a common means of establishing reperfusion in patients with acute MI, emergency physicians should be aware of such unusual complications secondary to fibrinolysis. An orderly clinical approach with an individualized management protocol is essential in such situations so that undue instrumentation and invasive procedures with their attendant risks in a thrombolysed patient are avoided.Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

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