TY - JOUR
T1 - Spontaneous mediastinal haematoma
T2 - A rare complication of warfarin therapy
AU - Jette, Leslie A.
AU - Niven, Alexander S.
AU - Nieves-Robbins, Neris
PY - 2011
Y1 - 2011
N2 - A 64-year-old woman presented with shortness of breath, right-sided pleuritic chest pain and dry cough. She was systemically anticoagulated with warfarin for a pulmonary embolism diagnosed 3 months previously, with an international normalised ratio (INR) of 3.0 on presentation. Chest radiograph demonstrated a new right paratracheal abnormality, and CT scan showed a large mediastinal mass not present 3 weeks earlier. MRI demonstrated an ovoid mass with a fl uid/fl uid level with high T2 and dark T1 signal consistent with a mediastinal haematoma. The patient's anticoagulation was emergently reversed and a temporary inferior vena cava fi lter was placed. The haematoma slowly resolved on serial follow-up with no additional intervention. Spontaneous mediastinal haematoma is a rare but life-threatening diagnosis that frequently presents with chest pain, dry cough and dysphagia. It is frequently associated with therapeutic anticoagulation and may potentially be caused by sudden, atraumatic rise in intrathoracic pressure (ie, cough or emesis).
AB - A 64-year-old woman presented with shortness of breath, right-sided pleuritic chest pain and dry cough. She was systemically anticoagulated with warfarin for a pulmonary embolism diagnosed 3 months previously, with an international normalised ratio (INR) of 3.0 on presentation. Chest radiograph demonstrated a new right paratracheal abnormality, and CT scan showed a large mediastinal mass not present 3 weeks earlier. MRI demonstrated an ovoid mass with a fl uid/fl uid level with high T2 and dark T1 signal consistent with a mediastinal haematoma. The patient's anticoagulation was emergently reversed and a temporary inferior vena cava fi lter was placed. The haematoma slowly resolved on serial follow-up with no additional intervention. Spontaneous mediastinal haematoma is a rare but life-threatening diagnosis that frequently presents with chest pain, dry cough and dysphagia. It is frequently associated with therapeutic anticoagulation and may potentially be caused by sudden, atraumatic rise in intrathoracic pressure (ie, cough or emesis).
UR - http://www.scopus.com/inward/record.url?scp=79955144291&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79955144291&partnerID=8YFLogxK
U2 - 10.1136/bcr09.2010.3316
DO - 10.1136/bcr09.2010.3316
M3 - Article
C2 - 22715229
AN - SCOPUS:79955144291
SN - 1757-790X
JO - BMJ case reports
JF - BMJ case reports
ER -