Spontaneous psoas hematoma in a case of acute myocardial infarction following streptokinase infusion

INTRODUCTION: Cardiovascular disorders are the major cause of mortality and morbidity globally as well as in India. In India, where resources are limited and majority of patients pay out of their own pocket, thrombolysis is still done for majority of STEMI cases. CASE SCENARIO: A 48-year-old male patient, nonhypertensive and nondiabetic, came to the ER with history of retrosternal chest pain suggestive of angina at rest. An Electrocardiogram (ECG) revealed ST-segment elevation in the anterior leads. Patient was diagnosed with Acute STEMI and thrombolysis was initiated with STK. The following day, the patient complained of pain in his left groin. On examination, there was a swelling and tenderness in left lower abdomen and inability to extend the hip. A CT scan was done, which showed Psoas muscle hematoma. CONCLUSION: Spontaneous bleed into psoas muscle is a very rare complication of thrombolysis that may require surgical exploration.