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March 1983

Spontaneous Mediastinal Hemorrhage: A Complication of Intracoronary Streptokinase Infusion for Coronary Thrombosis

Author Affiliations

From the Cardiovascular Section, Wood Veterans Administration Medical Center, and the Medical College of Wisconsin, Milwaukee.

Arch Intern Med. 1983;143(3):562-563. doi:10.1001/archinte.1983.00350030176031

• A 72-year-old man with a recent inferior-wall myocardial infarction complicated by continued ischemic cardiac pain underwent an intracoronary streptokinase infusion in an attempt to re-establish coronary perfusion. Although the cardiac catheterization and streptokinase infusion were technically uncomplicated, signs of an enlarging mediastinal mass associated with a drop in the hematocrit reading developed in the patient 12 hours after the procedure. Aortography showed no evidence of aortic dissection or laceration. The patient was believed to have a spontaneous mediastinal hemorrhage related to streptokinase infusion.

(Arch Intern Med 1983;143:562-563)