Aspirin-induced hemoptysis in a tertiary care centre – A case report

Abstract

Introduction: Aspirin, a commonly prescribed antiplatelet agent, is integral in the secondary prevention of cardiovascular diseases. However, its use is associated with various adverse effects, primarily bleeding complications. Hemoptysis, or the expectoration of blood from the lower respiratory tract, is a rare but potentially life-threatening side effect of aspirin therapy.

Case Details: We report the case of a 42-year-old male with a history of dilated cardiomyopathy and chronic alcohol use, who presented with hemoptysis after being on a daily dose of 75 mg aspirin (Ecosprin) for ischemic heart disease prophylaxis. Upon presentation, the patient’s vital signs were stable. Aspirin was promptly discontinued, and treatment included intravenous tranexamic acid and vitamin K. Comprehensive investigations, including blood tests, chest X-ray, and coagulation profile, were conducted. Elevated potassium levels, attributed to concurrent spironolactone use, were noted, and spironolactone was discontinued. The patient responded well to treatment and was subsequently discharged. The adverse event was classified as "Possible" based on the Naranjo ADR assessment scale.

Conclusion: This case underscores the importance of recognizing hemoptysis as a rare adverse effect of aspirin, especially in patients with additional risk factors. Prompt discontinuation of aspirin and appropriate supportive care are essential for managing such cases. Increased awareness and documentation of such adverse reactions are vital for improving patient safety.