© 2004 BMJ Publishing Group Ltd, British Association for Accident & Emergency Medicine, & Faculty of Accident & Emergency Medicine
CASE REPORT
Hard to swallow: an unusual complication of thrombolysis
Intensive Care Unit, St George Hospital, Sydney, Australia
Correspondence to:
Correspondence to:
Dr G C Price
Intensive Care Unit, St George Hospital, Gray Street, Kogarah, Sydney, Australia; grantcprice@hotmail.com
Accepted 8 September 2003
Keywords: thrombolysis
| The first 150 words of the full text of this article appear below. |
Thrombolysis for acute myocardial infarction always has a risk of causing haemorrhage.1 Both gastro-oesophageal reflux disease and ischaemic heart disease are common,2 and can have some overlap in their symptomatology. We present a patient who suffered an unusual complication of thrombolytic therapy.
An 80 year old man presented to his local emergency department with an acute inferior myocardial infarction. His only history of note was quadruple coronary artery bypass grafting at the age of 70, from which he had made a good recovery. He was assessed as appropriate for thrombolysis; tenectplase 37.5 mg, and aspirin 300 mg were given, and systemic heparinisation started. His electrocardiographic changes of myocardial infarction improved and reperfusion was thought to have occurred. An echocardiogram at 24 hours after admission reported moderate systolic dysfunction with infero-posterior akinesis, consistent with recent infarction. His troponin I concentrations were 0.64 µg/l, 14.1 µg/l, and 21.6 µg/l (normal range 0–0.1
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