Intravenous thrombolysis in a patient with left atrial myxoma with acute ischemic stroke

Girish Baburao Kulkarni1, Ravi Yadav1, Veerendrakumar Mustare1

  • 1Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Intravenous thrombolysis (IVT) is an accepted therapy in patients with acute ischemic stroke presenting within 3-4.5 hours of symptom onset. Selection of the patient for thrombolysis depends on the careful assessment for the risk of post thrombolysis symptomatic haemorrhage (6.2-8.9%) which may be fatal. Atrial myxomas which are the commonest tumors of the heart are associated with stroke due to tumor/clot embolism. There are very few case reports of IVT and its outcome in patients with atrial myxoma with stroke. Some have reported successful thrombolysis, while others have reported intracerebral bleeding. In this report we describe our experience of IVT in atrial myxoma patient with ischemic stroke and review the relevant literature.

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