Might life-threatening acute pulmonary edema occur after using recombinant tissue plasminogen activator? A case report

BMC Neurol. 2021 Sep 9;21(1):346. doi: 10.1186/s12883-021-02371-w.

Abstract

Background: Recombinant tissue plasminogen activator (rt-pa) is the first-line drug for the treatment of acute ischemic stroke, and can lead to some complications.There were rare reports of death due to acute pulmonary edema during rt-pa thrombolysis treatment.

Case presentation: This study reports a 30-year-old man was diagnosed with acute ischemic stroke and underwent rt-pa thrombolytic therapy. Finally he died despite active rescue.

Conclusions: The autopsy revealed that he died of acute pulmonary edema. This case suggests that it is necessary to pay close attention to the changes of vital signs during thrombolysis and be aware of possibility of pulmonary edema during thrombolysis.

Keywords: Acute ischemic stroke; Acute pulmonary edema; Case report; Forensic pathology; Recombinant tissue plasminogen activator.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Ischemia* / drug therapy
  • Fibrinolytic Agents / adverse effects
  • Humans
  • Male
  • Pulmonary Edema* / chemically induced
  • Pulmonary Edema* / drug therapy
  • Recombinant Proteins / therapeutic use
  • Stroke* / complications
  • Stroke* / drug therapy
  • Thrombolytic Therapy / adverse effects
  • Tissue Plasminogen Activator / adverse effects
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator