Peripherical embolism following streptokinase

pp 159-161

Abstract

In the last decade, thrombolytic therapy in acute myocardial infarction has modified the natural course and the mortality of coronary artery disease. Several adverse effects have been reported with the use of thrombolytic drugs, but there isn't much information about extra- coronary compIiætions, with exception of cerebrovascular strokes and major bleeds. The lysis and fractioning of the thrombus by the effect of these drugs and distal emboization, has rarely been reported. The patient that motivated this report, had the antecedent of an old anterior aneurism and a later aneurismectomy, that now presents a new diafragmatic myocardial infarction. He entered in the streptokinase protocol and showed a left humeral embolization three hours postinfussion, that needed surgical procedures. A routine echocardiography revealed an apical intraventricular thrombus, as the source of the embolic event. We recommend the routine echo cardiogram in any acute necrotic event, before the use of fibrinolytic therapy, in presence of a previous myocardial infarction or cardiac surgery and specially in those patients without warfarin therapy.