A rare complication of oral anticoagulant treatment: hemothorax

Çiledağ, Aydın; Çelik, Gökhan; Köycü, Gözde; Gürsoy, Eren; Yüksel, Cabir

doi:10.5578/tt.2463

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…A similar case reported by Çiledağ et al revealed spontaneous hemothorax due to warfarin therapy in the setting of atrial fibrillation, but their patient was managed conservatively owing to few blood depositions in the pleural space [6]. Pulmonary diseases including pleural pathologies were considered significant risk factors for developing nontraumatic hemothorax in the setting of anticoagulation.…”

Section: Discussionmentioning

confidence: 93%

Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

Doğan

Günaydın

Tekin³

et al. 2013

Case Reports in Emergency Medicine

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Hemorrhagic complications due to warfarin use are frequently seen in emergency departments. However, nontraumatic massive hemothorax is an unexpected complication. We report a 59-year-old woman with warfarin overdose, who had massive hemothorax in right lung without any history of trauma. Her main complaint was significant dyspnea, which has gradually increased in three days. On her physical examination, she was tachypneic and had decreased lung sounds on her right hemithorax. She took warfarin regularly for aortic and mitral valve replacement for 18 years. Her INR level was 12.9 (0.8–1.2). Computed tomography of thorax revealed massive hemothorax with mediastinal shift. Fresh frozen plasma infusion was started immediately. Tube thoracostomy was performed for reexpansion of right lung and 2000 cc blood was drained in 5 minutes. Although hemorrhagic complications can be expected in warfarin therapy, thoracic hemorrhage related to warfarin therapy is relatively rare (3% of all hemorrhagic complications due to warfarin therapy). To our knowledge, massive hemothorax due to warfarin use is an extremely rare condition.

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Section: Discussionmentioning

confidence: 93%

Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

Doğan

Günaydın

Tekin³

et al. 2013

Case Reports in Emergency Medicine

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“…During anticoagulant treatment, hemothorax can result from minor chest trauma or spontaneous small artery rupture. Spontaneous hemothorax has been reported following anticoagulation with an older oral anticoagulant, warfarin [10,11]. Rivaroxaban, a novel oral anticoagulant (NOAC), has a safer safety margin compared to warfarin.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Hemothorax caused by Rivaroxaban treatment for pulmonary embolism

Hariri

Alharafsheh

Nashwan

et al. 2023

Preprint

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Hemothorax is a rare and potentially fatal condition characterized by pleural effusion containing over 50% of the patient's hematocrit. A massive hemothorax involves blood loss exceeding 1.5 liters. Common causes include chest trauma, invasive thoracic procedures, anticoagulant medications, vascular anomalies, malignancies, and hematologic abnormalities. Spontaneous hemothorax may be seen in conjunction with pulmonary infarction and spontaneous pneumothorax. Anticoagulation is a key therapeutic strategy for certain thromboembolic events, such as pulmonary embolism. Historically, these events were treated with vitamin K antagonists (VKAs), which have demonstrated variable plasma concentrations and an increased risk of hemorrhage. With the advent of direct oral anticoagulants (DOACs), treatment has become as effective as VKAs while significantly reducing the risk of hemorrhage. However, some researchers have speculated that hemorrhagic complications in certain cases could be worse with DOACs than with VKAs. In the case presented here, we identified a genuine association between the use of rivaroxaban and spontaneous hemothorax following the initiation of treatment for pulmonary embolism.

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“…Spontaneous hemothorax following anticoagulation with an old oral anticoagulant (warfarin) has been reported. [8,9] Rivaroxaban is a NOAC that has safety margin more favorable than warfarin. To our knowledge, SH secondary to a NOAC (rivaroxaban) treatment has not been reported in the literature yet.…”

Section: Discussionmentioning

confidence: 99%

A case of rivaroxaban associated spontaneous hemothorax

Yıldız¹

2019

Turk Gogus Kalp Dama

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Valvüler olmayan atriyal fibrilasyonlu hastalarda tromboembolik korunma için varfarine alternatif olarak yeni oral antikoagülanlar ortaya çıkmıştır. Yeni oral antikoagülanlar varfarine göre daha iyi uyum ve güvenlik marjına sahip olmakla birlikte, kullanımları konusunda dikkatli olmalıyız. Bu yazıda, rivaroksaban tedavisine bağlı bir spontan hemotoraks olgusu sunuldu. Araştırmamıza göre, rivaroksaban tedavisine sekonder ilk spontan hemotoraks olgusu budur.

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A rare complication of oral anticoagulant treatment: hemothorax

Cited by 7 publications

References 8 publications

Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

Nontraumatic Massive Spontaneous Hemothorax with Concomitant Warfarin Use

Spontaneous Hemothorax caused by Rivaroxaban treatment for pulmonary embolism

A case of rivaroxaban associated spontaneous hemothorax

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