PMID- 29507028
OWN - NLM
STAT- MEDLINE
DCOM- 20180913
LR  - 20200305
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2018
DP  - 2018 Mar 5
TI  - Stroke thrombolysis complicated by ST elevation myocardial infarction (STEMI).
LID - bcr-2017-223580 [pii]
LID - 10.1136/bcr-2017-223580 [doi]
LID - bcr2017223580
AB  - An 84-year-old male Jehovah's Witness presented to the emergency department 
      1 hour after onset of left facial droop and left upper limb weakness. 
      Thrombolytic stroke treatment was commenced as per local thrombolytic protocol 
      with intravenous recombinant tissue plasminogen activator (rtPA) at 2 hours and 
      25 min following onset of symptoms. Almost immediately after rtPA infusion the 
      patient reported chest pain and had ECG changes consistent with a diagnosis of 
      anterior ST elevation myocardial infarction. At angiogram, a graft study showed 
      severe native coronary artery disease. The left internal mammary artery graft was 
      patent to the left anterior descending artery (LAD); however, the apical LAD was 
      occluded, with the appearance suggestive of embolic occlusion.
CI  - (c) BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 
      2018. All rights reserved. No commercial use is permitted unless otherwise 
      expressly granted.
FAU - Flower, Mark
AU  - Flower M
AUID- ORCID: 0000-0002-0983-2095
AD  - Department of Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
FAU - Harvey, James
AU  - Harvey J
AD  - Department of Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
FAU - Hunter, Jonathan
AU  - Hunter J
AD  - Department of Medicine, Redcliffe Hospital, Redcliffe, Queensland, Australia.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180305
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aged, 80 and over
MH  - Coronary Angiography
MH  - Coronary Artery Disease/complications/diagnostic imaging
MH  - Coronary Vessels/diagnostic imaging
MH  - Electrocardiography
MH  - Fibrinolytic Agents/administration & dosage/*adverse effects
MH  - Humans
MH  - Male
MH  - ST Elevation Myocardial Infarction/*etiology
MH  - Stroke/*complications/*drug therapy
MH  - Tissue Plasminogen Activator/administration & dosage/*adverse effects
MH  - Tomography, X-Ray Computed
PMC - PMC5847940
OTO - NOTNLM
OT  - ischaemic heart disease
OT  - safety
OT  - stroke
OT  - unwanted effects / adverse reactions
COIS- Competing interests: None declared.
EDAT- 2018/03/07 06:00
MHDA- 2018/09/14 06:00
PMCR- 2020/03/05
CRDT- 2018/03/07 06:00
PHST- 2018/03/07 06:00 [entrez]
PHST- 2018/03/07 06:00 [pubmed]
PHST- 2018/09/14 06:00 [medline]
PHST- 2020/03/05 00:00 [pmc-release]
AID - bcr-2017-223580 [pii]
AID - 10.1136/bcr-2017-223580 [doi]
PST - epublish
SO  - BMJ Case Rep. 2018 Mar 5;2018:bcr2017223580. doi: 10.1136/bcr-2017-223580.