Percutaneous Left Atrial Appendage Closure in a Patient with Diffuse Alveolar Hemorrhaging Associated with Anticoagulant Therapy and Atrial Fibrillation

Intern Med. 2022 Jul 1;61(13):2045-2050. doi: 10.2169/internalmedicine.8551-21. Epub 2021 Nov 27.

Abstract

Diffuse alveolar hemorrhaging (DAH) due to oral anticoagulation (OAC) is a life-threatening condition that leads to severe respiratory failure. There is a clinical dilemma in that OAC-induced DAH often forces the discontinuation of OAC therapy and the administration of high-dose corticosteroids, which increases the risk of stroke and cardiovascular events. We herein report the first case of OAC-induced DAH and atrial fibrillation (AF) in a patient who completely discontinued OAC therapy and high-dose corticosteroids after experiencing percutaneous left atrial appendage (LAA) occlusion. This case suggests that percutaneous LAA closure may aid in the management of OAC-induced DAH and AF.

Keywords: atrial fibrillation; corticosteroid; diffuse alveolar hemorrhaging; percutaneous left atrial appendage closure; respiratory failure.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / adverse effects
  • Atrial Appendage* / diagnostic imaging
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / surgery
  • Hemorrhage / chemically induced
  • Hemorrhage / complications
  • Humans
  • Male
  • Stroke* / complications
  • Stroke* / prevention & control
  • Treatment Outcome

Substances

  • Anticoagulants