A patient undergoing thrombolysis may rarely develop a compartment syndrome in an upper or lower extremity afterwards.


Reasons for thrombolysis:

(1) myocardial infarction

(2) pulmonary embolism

(3) arterial occlusion

(4) stroke

(5) deep vein thrombosis


Risk factors for compartment syndrome:

(1) fracture in the affected limb (which may be unrecognized)

(2) manipulation of the affected limb (arterial puncture, non-invasive blood pressure monitoring, intra-arterial cannula, etc)

(3) concurrent anticoagulation or antithrombotic therapy (aspirin, heparin, etc)


The onset of the compartment syndrome may be short (2 hours) or delayed (3 or 4 days).


Complications of the compartment syndrome may include:

(1) neuropathy

(2) ischemia with or withour gangrene


Risk factors for complications:

(1) unrecognized fracture

(2) patient unconscious or heavily sedated

(3) limb covered or not looked at

(4) multiple serious problems

(5) possibility of compartment syndrome not considered

(6) history of anticoagulation or antithrombotic therapy not available


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