Related Experiment Video
Updated: Sep 19, 2025
09:42
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
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Cardiac Rupture and Death Following Administration of Recombinant Tissue-Type Plasminogen Activator (rt-PA)
Takashi Saito1, Tatsuhito Ishii1, Tadashi Aoki1
1Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
Cureus
|June 16, 2025
Summary
Recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke can have fatal complications. This case highlights the need to screen for cardiac comorbidities before rt-PA administration to prevent adverse events.
Area of Science:
- Neurology
- Cardiology
- Pathology
Background:
- Recombinant tissue-type plasminogen activator (rt-PA) is a critical treatment for acute ischemic stroke.
- Its administration in the hyperacute phase carries potential risks and requires careful patient selection.
Observation:
- An 81-year-old male presented with ischemic stroke symptoms, including aphasia and right hemiparesis.
- CT angiography confirmed left internal carotid artery occlusion within two hours of stroke onset.
- The patient received rt-PA and underwent endovascular treatment.
Findings:
- During endovascular treatment, the patient experienced sudden cardiopulmonary arrest and could not be resuscitated.
- Autopsy revealed cardiac rupture secondary to subacute myocardial infarction in the left ventricular lateral wall as the cause of death.
Implications:
- This case underscores the importance of comprehensive screening for comorbidities, particularly cardiac conditions, prior to rt-PA administration.
- Strict adherence to eligibility criteria and thorough pre-treatment evaluation are crucial for optimizing patient safety in acute stroke management.
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