Abstract:
:An 81-year-old man presented with a large, infected right atrial thrombus that was refractory to anticoagulants and several courses of antibiotics. The risk of surgical removal of the thrombus, which was associated with a pacemaker electrode, was considered prohibitive. The patient was treated for 7 days with low-dose (40 mg/day) tissue-type plasminogen activator (t-PA). Hemostatic monitoring during infusion revealed (1) a plasma t-PA antigen that was approximately 5% of that achieved during short-course t-PA for acute myocardial infarction, (2) biochemical evidence of prolonged clot lysis, and (3) no significant depletion of fibrinogen or plasminogen. Nearly complete dissolution of the thrombus was observed. His bacteremia was eradicated by intravenous penicillin despite the presence of the pacemaker lead. This case highlights the benefits of combined antibiotic and thrombolytic therapy and documents for the first time the response of the human hemostatic system to prolonged t-PA infusion and the plasma t-PA levels attained when thrombolytic therapy is administered in this manner. Prolonged courses of fibrinolytic agents may be a good alternative to surgical intervention in selected patients with infected, right-sided intracardiac thrombi.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Chuang S,Mehta RH,Fay WPdoi
10.1002/clc.4950250709subject
Has Abstractpub_date
2002-07-01 00:00:00pages
346-9issue
7eissn
0160-9289issn
1932-8737journal_volume
25pub_type
杂志文章abstract::Lithium has been used for the treatment of bipolar disorder for more than 6 decades. Reports of cardiac side effects resulting in both benign electrocardiographic (ECG) changes and near fatal arrhythmias have been reported in the literature. A systematic literature search was conducted on 2 electronic databases-PubMed...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22822
更新日期:2017-12-01 00:00:00
abstract::There is scant information regarding the effect of exercise training begun soon after hospital discharge for myocardial infarction (MI) with respect to subsequent improvement in exercise tolerance, enhancement of regional myocardial perfusion, or left ventricular function. Accordingly, 19 post-MI patients (mean age 53...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150105
更新日期:1992-01-01 00:00:00
abstract::A patient with severe pulmonary hypertension secondary to the CREST syndrome variant of scleroderma is described. Acute reductions in both pulmonary artery pressure and total pulmonary resistance were seen with nifedipine and oxygen administration. Reductions in resistance were maintained for over one month with this ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070111
更新日期:1984-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22031
更新日期:2012-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22533
更新日期:2016-06-01 00:00:00
abstract::In 1350 patients with suspected acute myocardial infarction, serum potassium levels during the first 3 days in hospital was correlated to clinical history and clinical course. A higher incidence of hypokalemia was observed in women, in patients with hypertension, and in those on chronic diuretic treatment. Patients wi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960111005
更新日期:1988-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190112
更新日期:1996-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20776
更新日期:2010-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2010-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211103
更新日期:1998-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150409
更新日期:1992-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22300
更新日期:2014-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.23058
更新日期:2018-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23375
更新日期:2020-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150314
更新日期:1992-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20998
更新日期:2012-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22215
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:Noninvasive evaluation of left ventricular (LV) diastolic function was performed on 12 patients with atrial fibrillation (AF) using posterior aortic wall echocardiogram and a parameter for determining the optimal heart rate in patients with chronic atrial fibrillation was considered. METHODS:...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190316
更新日期:1996-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230704
更新日期:2000-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200514
更新日期:1997-05-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060709
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960180713
更新日期:1995-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20351
更新日期:2009-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20383
更新日期:2009-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130911
更新日期:1990-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23325
更新日期:2020-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20705
更新日期:2010-02-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验,评审
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更新日期:1990-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.21962
更新日期:2012-06-01 00:00:00