Spontaneous bilateral haemothorax with haemopericardium secondary to rivaroxaban

Abstract

What is known and objective Although the risk of major bleeding with non‐vitamin K antagonist oral anticoagulant (NOAC) is low, life‐threatening bleeding can occur. Case summary We report a case of an 81‐year‐old female with deep vein thrombosis who developed bilateral spontaneous haemothorax and haemopericardium after rivaroxaban therapy. Diagnostic thoracentesis revealed a grossly bloody pleural effusion. She was treated with factor eight inhibitor bypassing agent, but the result was not satisfactory. What is new and conclusion To our knowledge, this is the first case report of a concomitant presentation of spontaneous bilateral haemothorax and haemopericardium due to rivaroxaban use. This case highlights the potential risk of major haemorrhagic complication of NOAC, which could be life‐threatening and require emergent reversal.

Spontaneous hemothorax caused by concomitant low-dose rivaroxaban and itraconazole in a 95-year-old patient: case report and literature review

“…Four case reports were retrieved by inputting "spontaneous hemothorax" and "rivaroxaban" in PubMed (Table 3). [5][6][7][8] The ages of the patients ranged from 24 to 81 years, and three were women older than 60 years of age. The onset of the spontaneous hemothorax varied from 10 days to 4 months after taking rivaroxaban regularly.…”