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Cardiovascular Disease: Student/Resident Case Report Poster - Cardiovascular Disease I |

Fatal Pulmonary Hemorrhage Complicating Myocardial Infarction: How Much Anticoagulation Is Enough?

Vincent Gonzalez, MD; Gregory Means, MD; Xuming Dai, MD
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University of North Carolina Hospitals, Chapel Hill, NC


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):83A. doi:10.1016/j.chest.2016.08.091
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SESSION TITLE: Student/Resident Case Report Poster - Cardiovascular Disease I

SESSION TYPE: Student/Resident Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: The anticoagulation and antiplatelet strategies of patients with high-risk ST-elevation myocardial infarction (STEMI) can be a difficult balance of risk, especially for those that require an intra-aortic balloon pump (IABP). The incidence of major bleeding in patients that require GP IIb/IIIa inhibitors and heparin is 8.3% compared to 4.9% in those treated with bivalirudin alone; however, the latter are at increased risk of in-stent thrombosis. While the guidelines support GP IIb/IIIa inhibitors in high-risk situations and heparin for IABP, these therapies further increase bleeding risk. To illustrate these management difficulties, we present a high-risk STEMI complicated by fatal pulmonary hemorrhage.

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