TITLE:
Massive Thromboembolism from an Abdominal Aortic Aneurysm after Successful Thrombolysis for an Acute Myocardial Infarction
AUTHORS:
Fernando Luiz de Melo Bernardi, Paulo Cury Rezende, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Diogo Arantes Behling Pereira da Luz, Vera Demarchi Aiello, Whady Hueb
KEYWORDS:
Thromboembolism, Abdominal Aortic Aneurysm, Fibrinolysis, Myocardial Infarction
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.4 No.2,
February
2,
2015
ABSTRACT: Thrombolytic therapy is indicated to the treatment of patients with ST-elevation myocardial infarction or pulmonary embolism. Its indication should especially consider the risk of bleeding, but other complications might pose harm to patients. Although rarely reported, fibrinolysis can trigger thromboembolic phenomena from emboligenic sources such as aortic aneurysms. Clinicians should be aware of this life-threatening complication. In this case report, we present one patient admitted due to a ST-segment elevation acute myocardial infarction successfully treated with fibrinolytic treatment, but who evolved with a massive microembolism from an abdominal aortic aneurysm. Despite intensive medical care, the patient evolved with multiorganic failure due to distal microembolism to the guts and lower limbs, severe rhabdomyolysis and ultimately to death. In this challenging case, clinical, anatomical and histopathologic features are presented and discussed.