Alveolar Hemorrhage: A Rare Complication of Eptifibatide (Glycoprotein IIb/IIIa Inhibitor)

A 67-year-old man presented with symptoms of typical chest pain. An electrocardiogram (EKG) showed ST elevation at the inferior leads and ST depression at the anterior leads. His blood pressure was 80/50 mmHg with a pulse rate of 100 beats/min. The glycoprotein IIb/IIIa inhibitor (eptifibatide) was administrated and a primary percutaneous coronary intervention PCI was done. Despite the restoration of TIMI grade 3/3 flow, the patient’s blood pressure dropped and pulmonary edema occurred. On the second day following PCI, the hemoglobin level started to drop. While working up the case, the patient suddenly complained of dyspnea and had a bloody foamy discharge from his mouth. Due to severe hypoxemia orotracheal intubation was carried out. A chest x-ray revealed an alveolar hemorrhage. Treatment with high dose hydrocortisone was started and the patient went on mechanical ventilation for seven days. Following extubation, the patient was put under close observation for five days and then discharged from hospital without any complications. During a 3 month follow-up, he has remained symptom free.