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05:52

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Thrombolytics in infectious endocarditis associated myocardial infarction

A J Hunter1, D E Girard

  • 1Department of Medicine, Oregon Health Sciences University, Portland, Oregon, USA.

The Journal of Emergency Medicine
|December 1, 2001
PubMed

Insights

Thrombolytic therapy for myocardial infarction can be fatal if infectious endocarditis is present, due to risks of brain hemorrhage. Always diagnose the cause of myocardial infarction to avoid contraindications.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Thrombolytic therapy is standard for acute myocardial infarction.
  • Infectious endocarditis can lead to embolic events, including myocardial infarction.
  • Intracerebral mycotic aneurysms are a known complication of infectious endocarditis.

Observation:

  • A case of embolic myocardial infarction secondary to infectious endocarditis is presented.
  • The patient received thrombolytic therapy.
  • This resulted in a fatal massive intracerebral hemorrhage.

Findings:

  • Infectious endocarditis is not commonly listed as a contraindication for thrombolytics.
  • Literature indicates a significant incidence of concurrent intracerebral mycotic aneurysms in endocarditis.
  • The patient's death was attributed to intracerebral hemorrhage following thrombolytic treatment.

Implications:

  • Accurate etiologic diagnosis of myocardial infarction is crucial.
  • Identifying contraindications like endocarditis is vital before thrombolytic use.
  • Alternative treatments should be considered when contraindications exist to prevent fatal complications such as hemorrhage.

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