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[A case of diffuse alveolar hemorrhage developing after open heart surgery]
Y Nakamura1, S Shimokawa, S Watanabe
1Second Department of Surgery, Kagoshima University Faculty of Medicine, Kagoshima, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 14, 2001
Summary
Anticoagulant therapy can cause diffuse alveolar hemorrhage in patients post-heart surgery. This condition, marked by lung infiltrates, requires prompt diagnosis and treatment with steroids and medication cessation.
Area of Science:
- Pulmonary Medicine
- Cardiovascular Surgery
Background:
- A 47-year-old male patient underwent coronary artery bypass grafting and mitral valve plasty.
- The patient was on anticoagulant therapy post-surgery.
Observation:
- Chest roentgenogram revealed bilateral alveolar infiltrates six months after surgery.
- Lung biopsy identified hemosiderin-laden macrophages, indicating diffuse alveolar hemorrhage.
Findings:
- Diffuse alveolar hemorrhage was diagnosed, likely induced by anticoagulant therapy.
- The patient's condition improved significantly after steroid therapy and discontinuation of anticoagulants.
Implications:
- Diffuse alveolar hemorrhage should be considered in patients with lung infiltrates post-cardiac surgery on anticoagulants.
- Lung biopsy is crucial for diagnosis when bronchoalveolar lavage is inconclusive.