Document Detail


Free wall rupture following rescue angioplasty and intravenous abciximab for failed thrombolysis.
MedLine Citation:
PMID:  11501328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early thrombolytic therapy reduces the risk of cardiac rupture but delayed thrombolysis may increase this risk, despite improving overall survival. The mechanism appears to be related to both unsuccessful early reperfusion and haemorrhagic transformation following delayed reperfusion. The effect of antiplatelet therapy with glycoprotein IIb-IIIa receptor blockers (abciximab) on cardiac rupture is unknown. It is possible that they may contribute to cardiac rupture by promoting haemorrhagic transformation of the infarcted area. In this report we describe a 57 year old man who underwent emergency coronary angioplasty and stenting following failed thrombolytic therapy for an acute anterior myocardial infarction. A suboptimal result was obtained which necessitated an intravenous bolus of abciximab followed by an infusion. He abruptly developed electromechanical dissociation. Echocardiogram confirmed pericardial tamponade and a pericardial drain was inserted but the patient could not be resuscitated. Postmortem examination confirmed a large transmural rupture of the infarcted anterior wall which had undergone haemorrhagic transformation.
Authors:
K P Balachandran; K G Oldroyd
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Scottish medical journal     Volume:  46     ISSN:  0036-9330     ISO Abbreviation:  Scott Med J     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-08-14     Completed Date:  2001-12-13     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  2983335R     Medline TA:  Scott Med J     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  87-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hairmyres Hospital, East Kilbride, Glasgow G75 8RG.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / administration & dosage,  adverse effects*,  therapeutic use
Fatal Outcome
Heart Rupture, Post-Infarction / chemically induced*
Humans
Immunoglobulin Fab Fragments / administration & dosage,  adverse effects*,  therapeutic use
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction / therapy*
Platelet Aggregation Inhibitors / administration & dosage,  adverse effects*,  therapeutic use
Stents
Thrombolytic Therapy*
Treatment Failure
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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