Severe orolingual angioedema leading to intubation after tenecteplase administration

We present the case of a 67-year-old patient who was admitted for a cardiac procedure. Postprocedure the patient experienced hyperacute-onset language deficits. After ruling out contraindications and discussing the risks and benefits, intravenous tenecteplase (TNK) was administered for suspected acute ischemic stroke. Subsequently, the patient developed severe orolingual edema leading to intubation. The patient's condition improved with daily steroids, histamine 2 receptor blocking agents, and antihistamine medications, and she was ultimately discharged home in a stable condition. It is important to remember the possible side effects of intravenous thrombolysis treatment, as timely diagnosis and management can significantly impact the overall prognosis.