Vocal cord haematoma after tenecteplase thrombolysis

At present, thrombolysis remains the principal reperfusion strategy for ST-elevation acute coronary syndromes in most countries, due to the limited availability of primary angioplasty. Haemorrhagic complications, which are among the most frequent side effects, are usually not very important. As a matter of fact, 70% of the bleeding takes place at venepuncture sites and does not require special treatment. We report an unusual case of vocal cord haematoma after thrombolysis with tenecteplase in a patient with acute myocardial infarction. As far as we know, this type of side effect has only been described once in the literature, namely, after thrombolysis with tissue plasminogen activator in deep vein thrombosis.