Regression of ST Segment Elevation After Thrombolysis in Acute Aortic Dissection

Safi, J.; Mansur, Alfredo José; Brito, F. S.; Benvenuti, L.; Ratti, M; Ramires, José Antônio Franchini

doi:10.1097/00007611-199611000-00013

Cited by 3 publications

(1 citation statement)

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“…Since the dissection can partially occlude the ostium of a coronary artery, it can modify the blood flow and pressure inside the vessel, leading to coronary thrombosis and consequent myocardial infarction. Tenekteplase, by dissolving the thrombi through the false lumen of the coronary artery and aortic root, allowed reperfusion, but later led to further bleeding and occlusion [7]. Another possibility is that a coronary spasm was the cause of the STEMI, due to nearby hematoma or pressure of the false lumen which resolved with the use of the adjuvant therapy, such as nitrates.…”

Section: Discussionmentioning

confidence: 99%

A successfully thrombolysed acute inferior myocardial infarction due to type A aortic dissection with lethal consequences: the importance of early cardiac echocardiography

Tsigkas

Kasimis

Θεοδωρόπουλος

et al. 2011

J Cardiothorac Surg

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Thrombolysis, a standard therapy for ST elevation myocardial infarction (STEMI) in non-PCI-capable hospitals, may be catastrophic for patients with aortic dissection leading to further expansion, rupture and uncontrolled bleeding. Stanford type A aortic dissection, rarely may mimic myocardial infarction. We report a case of a patient with an inferior STEMI thrombolysed with tenecteplase and followed by clinical and electrocardiographic evidence of successful reperfusion, which was found later to be a lethal acute aortic dissection. Prognostic implications of early diagnosis applying transthoracic echocardiography (TTE) are described.

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Section: Discussionmentioning

confidence: 99%