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Diffuse alveolar hemorrhage associated with low molecular weight heparin and dual anti-platelet therapy after

Fatma Yıldırım1, İskender Kara2, Hızır Okuyan3

  • 1Intensive Care Training Program, Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.

The Clinical Respiratory Journal
|January 20, 2016
PubMed

A 54-year-old man underwent percutaneous coronary intervention (PCI) and two stents were placed on left anterior coronary artery and circumflex artery. Low molecular weight heparin (LMWH) together with ticagrelor 90 mg twice a day and acetylsalicylic acid (Aspirin) were started after PCI due to high risk of stent thrombosis. On the fourth day of patient's follow-up in the intensive care unit (ICU), bloody secretion was started from endotracheal tube. Hemoglobin dropping, bilateral infiltration on the chest X-ray and bleeding from lung were diagnosed as diffuse alveolar hemorrhage (DAH). Apart from LMWH and antiplatelet therapies with aspirin and ticagrelor, there were no other identified risk factors for DAH. As far as we know, our report is the first case of DAH caused by LMWH and dual anti-platelet therapy including ticagrelor.

Keywords:
antithrombotic therapydiffuse alveolar hemorrhagelow molecular weight heparinpercutaneous coronary intervention

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