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Streptokinase Lysis of Intraventricular Thrombus and Pulmonary Emboli with Resolution of Acquired Intracardiac Shunt

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▸Requests for reprints should be addressed to Mohandas M. Shenoy, M.D.; Cardiology Division, Suite 6N2, Coney Island Hospital, 2601 Ocean Parkway; Brooklyn, NY 11235.

Ann Intern Med. 1985;103(1):65-66. doi:10.7326/0003-4819-103-1-65
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Streptokinase has been used successfully for several thromboembolic disorders. In the case reported here, intravenous infusion of streptokinase eliminated right-to-left intracardiac shunting in a patient with acute pulmonary embolism. This treatment simultaneously lysed a left ventricular thrombus. The shunting site and thrombolysis were shown echocardiographically.

A 94-year-old man was hospitalized with acute dyspnea and left arm paralysis. His history included a myocardial infarction but no neurologic disease. Physical findings included a temperature of 36.8 °C; pulse, 75 beats/min; blood pressure, 90/50 mm Hg; central cyanosis, tachypnea, and jugular venous distension. Heart sounds were normal and lungs were clear. His left


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