Diffuse alveolar hemorrhage secondary to antiplatelet therapy: a rare complication

Introduction Diffuse alveolar hemorrhage (DAH) is a life-threatening condition that can quickly lead to respiratory failure. Its occurrence due to antiplatelet therapy is rare, particularly during acute coronary syndrome (ACS) treatment. This report presents a notable case of DAH in a 74-year-old man following antiplatelet use after percutaneous coronary angioplasty. Case discussion A 74-year-old male with a history of hypertension and heavy smoking presented with shortness of breath and chest pain, later diagnosed with ST-elevation myocardial infarction (STEMI). He underwent successful PCI with stenting of the left circumflex artery. Post-procedure, he developed hemoptysis and respiratory distress; imaging and bronchoalveolar lavage indicated diffuse alveolar hemorrhage (DAH), suspected to be caused by antiplatelet therapy. Ticagrelor was discontinued and corticosteroids initiated, leading to gradual improvement. The patient recovered well and was discharged, remaining stable on follow-up 8 months later. Conclusion Diffuse alveolar hemorrhage (DAH) is a life-threatening emergency that can resemble acute pulmonary edema, making early suspicion and diagnosis essential for proper treatment.