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A life-threatening massive hemoptysis case in the course of dual antiplatelet therapy with ticagrelor

A chest computed tomography (chest CT) revealed diffuse ground glass infiltrates in the apical and posterior segments of the right upper lobe and alveolar infiltrates in the remainder of the lungs, findings compatible with diffuse alveolar hemorrhage (images could not be retrieved due to technical reasons). Recent bleeding originating from the right bronchial tree was the finding of ABSTRACT Massive hemoptysis is a life-threatening medical condition which usually occurs in the course of parenchymal destructive diseases. We herein report the case of a 61-year-old male patient who presented with massive hemoptysis six months after commencement of dual antiplatelet therapy with acetylsalicylic acid and ticagrelor, for drug-eluting coronary stents. Control of bleeding with discontinuation of both antiplatelet agents, as well as negative imaging and laboratory studies for other pulmonary hemorrhage causes, indicate that either of the antiplatelet drugs or combination thereof was the cause of the pulmonary hemorrhage. In contrast to the previous limited case reports with pulmonary hemorrhage early during antiplatelet therapy with ticagrelor, this case highlights that it can even occur later in the course of antiplatelet therapy.