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Japanese

A case with sudden obstruction of the left main coronary artery treated by intravenous thrombolysis Yoshikazu Hiasa 1 , Toshihiro Maeda 1 , Shinzi Morimoto 1 , Michinori Harada 1 , Tsukasa Aihara 1 , Masaaki Bando 1 , Yoshihiro Nakai 1 , Yoshihiko Kataoka 1 , Hiroyoshi Mori 2 1Department of Cardiology, Komatsushima Red Cross Hospital 22nd Department of Internal Medicine, Tokushima University pp.1169-1173
Published Date 1985/9/15
DOI https://doi.org/10.11477/mf.1404204749
  • Abstract
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A 10-year-old man with severe chest pain and loss of consciousness was transferred to our hospital. He had a systolic blood pressure of 60mmHg and his electrocardiogram (ECG) showed ST elevation on leads I, AVL and V2~6. 240,000 IU of urokinase were infused intravenously 50 minutes after the onset of chest pain. Immediately after it, a monitor ECG showed Torsade de pointes type ventricular arrhythmia. Sinus rhythm was restored after a direct-current cardiovarsion. Few minutes later, his chest pain was almost disappeared. Coronary angiographyshowed a small thrombus in the left main coronary artery (LMC). The dominant right coronary artery had no organic stenosis. At cardiac catheterization, the cardiac index was 7.6 l/min/m2, the left ventri-cular enddiastolic pressure was 22mmHg. In the chronic state, two-dimensional echocardiograms showed hypokinesis of the anterior septal regions,and 201Tl scintigrams showed no perfusion defects. This rare case suggest that in a case with acute LMC obstruction and cardiogenic shock, a high dose intravenous infusion of urokinase is effective not only for saving a life but also for salvaging injuried myocardium.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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