Myocardial infarction following recombinant tissue plasminogen activator treatment for acute ischemic stroke： a dangerous complication

Thrombolysis with intravenous tissue plasminogen activator （t-PA） is currently an approved therapy for patients with acute ischemic stroke. Acute myocardial infarction （AMI） immediately following t-PA treatment for stroke is a rare but serious complication. A case of acute myocardial infarction （MI） following IV t-PA infusion for acute stroke was observed. This is a 52-year-old male with a known history of hypertension and chest pain, who subsequently developed MI four hours after IV t-PA was administered for acute ischemic stroke. The disruption of intra-cardiac thrombus and subsequent embolization to the coronary arteries may be an important mechanism. In addition, spontaneous recanalization of infarct-related arteries may be associated with greater myocardial salvage and better prognosis.