ABSTRACT
A 62 year old woman admitted with a history suggesting acute myocardial infarction had thrombolytic treatment with anisoylated plasminogen-streptokinase activator complex, which resulted in submucosal haemorrhage in the oesophagus; this caused dissection of the wall of the oesophagus and complete dysphagia. The haematoma resolved spontaneously, leaving behind a diverticulum, with reduced peristalsis and delayed emptying but no obstruction.
Subject(s)
Anistreplase/adverse effects , Esophageal Diseases/chemically induced , Gastrointestinal Hemorrhage/chemically induced , Myocardial Infarction/drug therapy , Thrombolytic Therapy/adverse effects , Deglutition Disorders/chemically induced , Diverticulum, Esophageal/chemically induced , Female , Humans , Middle Aged , Tomography, X-Ray ComputedABSTRACT
Medical audit in a district general hospital coronary care unit led to the introduction of an emergency cardiac enzyme service. 91.2% of patients eligible for thrombolysis therapy received treatment following this introduction compared to 73.7% before (P = .05). No patient was treated inappropriately on the basis of a raised cardiac enzyme.