[Cardiac arrest caused by massive pulmonary embolism during treatment with tranexamic acid]

Pulmonary embolism (PE) as the direct cause of cardiac arrest is well known but probably under-diagnosed. Treatment of menorrhagia with antifibrinolytics is a well documented treatment modality and it is considered safe although thromboembolic complications have been reported. We describe a case of a 30-year-old otherwise healthy woman, who had been treated with antifibrinolytics for up to six months prior to the event, presenting with fatal acute, massive PE and cardiac arrest, which was treated with prompt resuscitation including thrombolysis with recombinant tissue plasminogen activator and subsequent return of spontaneous circulation.