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Int J Angiol
DOI: 10.1055/s-0042-1756487
Case Report

Acute Mediastinal Bleeding with Pleural Escape: Case Report of a Rare Interventional Complication with Unusual Resolve

Wishnu Aditya Widodo
1   Division of Interventional Cardiology, Jakarta Heart Center, Jakarta, Indonesia
,
Arif Mansjoer
2   Division of Cardiac Intensive Care, Jakarta Heart Center, Jakarta, Indonesia
,
Ismail Dilawar
3   Division of Cardiothoracic Surgery, Jakarta Heart Center, Jakarta, Indonesia
,
Andri Kurnia
4   Division of Cardiac Anesthesia, Jakarta Heart Center, Jakarta, Indonesia
,
Daniel Ruslim
5   Division of Radiology, Jakarta Heart Center, Jakarta, Indonesia
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Abstract

Acute mediastinal bleeding is a very rare complication of cardiac intervention. It is a life-threatening situation when this condition causes acute compression of the mediastinal area. A 59-year-old man was diagnosed with inferior ST-elevation myocardial infarction with ongoing chest pain and underwent an urgent percutaneous coronary intervention procedure. After coronary stent was implanted, patient complained of chest tightness, and suffocation, blood pressure dropped, O2 saturation dropped, and was difficultly intubated. Image acquisition by C-arm showed a large bulging in aortic arch area. Contrast-enhanced computed tomography ruled out aortic dissection, but noted a large mediastinal mass that was radiated to the neck. The bulging was spontaneously regressed, and a large left pleural effusion was developed. Left pleural tapping was performed on day 7, and a total of 1.5-L hemorrhagic fluid was evacuated. In our case, unusual drainage from mediastinal to pleural space has probably save the patient.

Keywords

acute mediastinal bleeding - acute mediastinal compression - pleural escape - rare complication - percutaneous coronary intervention - ST-elevation myocardial infarction - life-threatening


Publication History

Article published online:
26 September 2022

© 2022. International College of Angiology. This article is published by Thieme.

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