Massive Thromboembolism from an Abdominal Aortic Aneurysm after Successful Thrombolysis for an Acute Myocardial Infarction

Fernando Luiz de Melo Bernardi¹, Paulo Cury Rezende¹, Cibele Larrosa Garzillo¹, Eduardo Gomes Lima¹, Diogo Arantes Behling Pereira da Luz¹, Vera Demarchi Aiello², Whady Hueb^1*

¹Department of Atherosclerosis, Heart Institute of the University of Sao Paulo, Sao Paulo, Brazil.
²Department of Pathology, Heart Institute of the University of Sao Paulo, Sao Paulo, Brazil.

DOI: 10.4236/crcm.2015.42011                

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.

Keywords

Thromboembolism, Abdominal Aortic Aneurysm, Fibrinolysis, Myocardial Infarction

Conflicts of Interest

The authors declare no conflicts of interest.

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