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- Title
Lesson of the month 1: Pneumonitis and pulmonary haemorrhage after acute myocardial infarction.
- Authors
Parasuraman, Sathish K.; Teo, Alison I. C.; Millar, Colin G. M.; Noman, Awsan
- Abstract
A 55-year-old man presented with acute ST-elevation myocardial infarction. He received rescue angioplasty with one drug eluting stent. He developed marked breathlessness and haemoptysis two days later. Investigations led to the diagnosis of pulmonary haemorrhage, possibly from pneumonitis caused by ticagrelor. He was successfully managed with high-dose steroids and ticagrelor was replaced with clopidogrel. On stopping the steroids a month later, mild haemoptysis recurred and this was managed conservatively. Pneumonitis and pulmonary haemorrhage is rarely reported with acute myocardial infarction, but poses serious challenge to the patient and the clinician. Diagnosis may be delayed as breathlessness can occur due to myriad causes after myocardial infarction. Interrupting dual anti-platelet therapy after angioplasty could lead to devastating stent thrombosis.
- Subjects
HEMORRHAGE diagnosis; LUNG disease diagnosis; MYOCARDIAL infarction complications; PNEUMONIA diagnosis; CHEST X rays; COMPUTED tomography; DYSPNEA; ELECTROCARDIOGRAPHY; HEMOPTYSIS; HEMORRHAGE; LUNG diseases; MYOCARDIAL infarction; PNEUMONIA; STEROIDS; PLATELET aggregation inhibitors; DRUG-eluting stents; CORONARY angiography
- Publication
Clinical Medicine, 2015, Vol 15, Issue 6, p591
- ISSN
1470-2118
- Publication type
Article
- DOI
10.7861/clinmedicine.15-6-591