Complete dysphagia after thrombolytic treatment for myocardial infarction

An 82 year old man was admitted to hospital with unstable angina pectoris. There was a long history of minor symptoms suggesting reflux disease, with a small diaphragmatic hernia. One day after admission the patient complaine d of severe chest pain. An acute inferior-posterior myocardial infarction w as diagnosed on EGG, and thrombolytic treatment with alteplase (rt-PA) was initiated. Within a few hours total dysphagia occurred, caused by haemorrha gic oesophagitis. The haematoma resolved spontaneously within about 10 days . The patient was discharged three weeks later after full resolution of the dysphagia.