Abciximab, a platelet glycoprotein IIb/IIIa receptor blocker, is a well-known agent
in percutaneous coronary intervention because of its antiplatelet, antithrombotic
effects, which allow for good outcome. Major bleeding is a well-recognized complication
of abciximab therapy, and pulmonary hemorrhage, although infrequent, is a serious,
under-recognized, and often fatal complication. We describe a case of fatal pulmonary
hemorrhage in a young woman who presented with acute myocardial infarction and cardiogenic
shock and was treated with abciximab in conjunction with percutaneous coronary intervention.
The possibility of diffuse pulmonary hemorrhage should be strongly suspected in the
presence of hypoxemia, infiltrates on chest radiography, and a decrease in hemoglobin.
Awareness about this complication of abciximab therapy on the part of physicians and
health care professionals is strongly warranted. Therapy that may be used if diagnosis
is promptly made includes bronchoscopic-guided balloon tamponade or iced saline lavage.
These therapeutic interventions are still in the developmental stage, and to date
there are no trials to document their efficacy and survival benefit.
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© 2006 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
