Massive Spontaneous Haemothorax after Rivaroxaban Therapy for Acute Pulmonary Embolism

• Main Authors: Yan Denise Tan, Kai Heng Raymond Goh, Heng Joo Ng
• Format: Article
• Language: English
• Published: SMC MEDIA SRL 2019-09-01
• Series: European Journal of Case Reports in Internal Medicine
• Subjects: spontaneous haemothorax; pulmonary embolism; pulmonary infarction; rivaroxaban; anticoagulation
• Online Access: https://www.ejcrim.com/index.php/EJCRIM/article/view/1236

Spontaneous haemothorax complicating the treatment of pulmonary embolism is rare and potentially fatal. We describe a patient with pulmonary embolism and severe pleuritic pain who developed a life-threatening haemothorax 10 days later while on rivaroxaban therapy. This case highlights the fact that severe pleuritic pain associated with pulmonary embolism may indicate subclinical infarction of tissue near the visceral pleura with an increased risk of pleural effusion and the subsequent development of a haemothorax. It is important to recognise such danger signs warranting closer attention, especially since the increased use of direct oral anticoagulants has facilitated ambulatory care and this complication may manifest in the outpatient setting.