dc.contributorUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:20:32Z
dc.date.accessioned2022-10-05T17:47:30Z
dc.date.available2014-05-27T11:20:32Z
dc.date.available2022-10-05T17:47:30Z
dc.date.created2014-05-27T11:20:32Z
dc.date.issued2002-12-01
dc.identifierJournal of Medicine, v. 33, n. 5-6, p. 335-337, 2002.
dc.identifier0025-7850
dc.identifierhttp://hdl.handle.net/11449/67025
dc.identifier2-s2.0-34648822601
dc.identifier1590971576309420
dc.identifier9418970103564137
dc.identifier4463138671998432
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/3916719
dc.description.abstractAlthough rare, major bleeding is the most important side effect of thrombolytic therapy in acute myocardial infarction (AMI) (Levine et al., 1995). Spontaneous hepatic bleeding in normal liver after thrombolytic administration has rarely been reported in literature. To our knowledge, there are only three cases of hepatic bleeding related to thrombolytic therapy in AMI. In these, the used drugs were anisolylated plasminogen streptokinase activator complex (APSAC) (Garcia-Jiménez et al., 1997; Fox et al., 1991) and rt-PA (Garcia-Jiménez et al., 1997). We report a case of hepatic bleeding after streptokinase followed by units over 60 minutes). The next day, the patient developed third-degree atrioventricular block and a temporary pacemaker was inserted. Twenty-seven hours after streptokinase infusion, the patient complained of refractory chest pain that was interpreted as post-myocardial infarction angina; clotting screen was normal and intravenous heparin was started (80 U/kg followed by 18 U/kg/hour). After four hours of heparin administration, the patient presented abdominal pain and distension, and his blood pressure and hematocrit level dropped. Abdominal ultrasonography revealed free fluid in the peritoneal cavity (about 3,000 mL). A laparotomy disclosed blood in the abdominal cavity with bleeding from the right lateral hepatic segment, which was removed. The remaining abdominal viscera were normal and there was no other evidence of hemorrhage. The partial liver resection presented subcapsular hemorrhage with small parenchymal hemorrhage. Histopathological examination also revealed focal areas of ischemic centrilobular necrosis. The patient died of multiple organ system failure 21 days after admission. Copyright © 2002 By PJD Publications Limited.
dc.languageeng
dc.relationJournal of Medicine
dc.rightsAcesso restrito
dc.sourceScopus
dc.subjectAcute myocardial infarction (AMI)
dc.subjectMajor bleeding
dc.subjectSide effect of thrombolytic therapy
dc.subjectSpontaneous hepatic bleeding
dc.subjectThrombolytic therapy in AMI
dc.subjectalteplase
dc.subjectanistreplase
dc.subjectheparin
dc.subjectstreptokinase
dc.subjectabdominal distension
dc.subjectabdominal pain
dc.subjectacute heart infarction
dc.subjectclinical feature
dc.subjectdeath
dc.subjectechography
dc.subjectfibrinolytic therapy
dc.subjecthistopathology
dc.subjecthuman
dc.subjecthypotension
dc.subjectlaparotomy
dc.subjectliver hemorrhage
dc.subjectmultiple organ failure
dc.subjectpartial hepatectomy
dc.subjectside effect
dc.subjectthorax pain
dc.titleHepatic bleeding induced by streptokinase and heparin in a patient with acute myocardial infarction
dc.typeArtigo


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