Reteplase-induced Hypotension in Patients Undergoing Thrombolysis in Acute Myocardial Infarction- Case Series

Abstract

Introduction: Reteplase is the second-generation tissue plasminogen activator used as a thrombolytic agent for myocardial infarction patients. It has better tolerability as compared to streptokinase. Bleeding is one of the recorded side effects of reteplase. Case presentation: In this case, a series of 2 patients noticed an incidence of hypotension after the infusion of the Reteplase with an average onset in 20- 30 minutes after the first dose of Reteplase. Of the two patients encountered with the event of hypotension secondary to Reteplase, a 68-year-old male was diagnosed with anterior wall MI, and a second patient of age 55 years old, was diagnosed with anterolateral wall MI. Reteplase-induced hypotension is relatively uncommon in the literature and documented reports. All patients recovered in the period. Conclusion: Two patients encountered hypotension after the infusion of Reteplase can come under “Possible” adverse drug reaction according to the WHO causality assessment. The possible mechanism of action for the incidence of hypotension post-thrombolysis or during thrombolysis may be assigned to releasing the inflammatory mediators secondary to the hypersensitivity reaction. Both Patients recovered with the symptomatic therapy.