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Fatal Hemoptysis during Coronary Thrombolysis
1Division of Cardiology and Pulmonary Medicine, Bronx-Lebanon Hospital Center, Bronx, New York; Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, New York and Department of Pathology, Bronx-Lebanon Hospital Center, Bronx, New York.
Abstract:
Cerebral hemorrhage is the most dreaded complication of coronary thrombolysis. Significant bleeding has also been described from catheter-entry sites, the retroperitoneum, and the gastrointestinal and genitourinary tracts. However, hemoptysis induced by thrombolysis has rarely been described in the literature. We present a 66-year-old male who received front-loaded tissue plasminogen activator (tPA) for acute transmural anterior wall myocardial infarction and developed massive hemoptysis from preexisting cavitary lung disease. The patient died within 5 hours. We believe this is the first case report of fatal hemoptysis induced by coronary thrombolysis. A history of cavitary lung disease may be a risk factor for life-threatening hemoptysis in patients receiving thrombolytic therapy.