Complicated Hemothorax after Administration of Aspirin, Dipyridamole and Nadroparine for Brain Infarction-A Case Report

A 75-year-old man arrived at the Keelung Chang-Gung Hospital emergency department due to a choking episode. CPR was successfully performed. A chest radiography done afterward revealed pneumonia located in the left lung, with no evidence of rib fracture. The patient remained unconscious for 7 days after our administration of CPR. The attending neurologist diagnosed a brain infarction, for which aspirin, dipyridamole and nadroparine were prescribed. Progressive ecchymosis on the left forearm and hemothorax in the left chest developed 6 days after administration of ASA and LMWH, resulting in a 21.6% decrease in hematocrit. The hemothorax required tube thoracostomy and a blood transfusion. Aspirin, dipyridamole and nadroparine were discontinued and the hemothorax did not recur. The possibility of complicated hemothorax must be considered in patients for whom low molecular weight heparin, aspirin, and dipyridamole are concurrently prescribed.