Department of Respiratory, Kokura Memorial Hospital, Japan.
Department of Cardiovascular Medicine, Kokura Memorial Hospital, Japan.
Intern Med. 2022 Jul 1;61(13):2045-2050. doi: 10.2169/internalmedicine.8551-21. Epub 2021 Nov 27.
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.
弥漫性肺泡出血(DAH)是由口服抗凝剂(OAC)引起的,可导致严重的呼吸衰竭,是一种危及生命的病症。存在一个临床难题,即 OAC 引起的 DAH 常迫使停止 OAC 治疗并给予大剂量皮质类固醇,这会增加中风和心血管事件的风险。我们在此报告首例因接受经皮左心耳(LAA)封堵术而完全停止 OAC 治疗和大剂量皮质类固醇治疗的 OAC 诱导的 DAH 和心房颤动(AF)的患者。该病例表明,经皮 LAA 封堵术可能有助于 OAC 诱导的 DAH 和 AF 的治疗。