Reperfusion pulmonary edema after thrombolytic therapy of massive pulmonary embolism

Am Rev Respir Dis. 1988 Nov;138(5):1308-11. doi: 10.1164/ajrccm/138.5.1308.


We report here the occurrence of acute focal pulmonary edema after thrombolytic therapy for massive pulmonary embolism. Symptomatic pulmonary edema developed in a 75-yr-old man after streptokinase infusion for a massive pulmonary embolism. Repeat radiographic studies demonstrated that the edema occurred in an area of early reperfusion. Right heart catheterization showed pulmonary hypertension, and there was no clinical evidence of left ventricular failure. The edema spontaneously resolved during a second course of thrombolytic therapy that successfully lysed the remaining thrombus. We conclude that reperfusion pulmonary edema is a potential, albeit rare, complication of thrombolytic therapy for pulmonary embolism.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Angiography
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Pulmonary Edema / chemically induced*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / drug therapy*
  • Radiography, Thoracic
  • Radionuclide Imaging
  • Reperfusion Injury / chemically induced*
  • Streptokinase / adverse effects*
  • Streptokinase / therapeutic use
  • Urokinase-Type Plasminogen Activator / therapeutic use


  • Fibrinolytic Agents
  • Streptokinase
  • Urokinase-Type Plasminogen Activator