A 64-year-old man presented with worsening dyspnea on exertion and hemothor
ax of the left chest 7 days after discharge from the hospital on ticlopidin
e and aspirin after coronary stent placement to his left circumflex artery.
He had suffered traumatic rib fractures to the seventh, eighth, and ninth
left ribs 28 days before this presentation and 21 days before starting the
ticlopidine. Results of chest radiography at discharge 7 days earlier while
on aspirin and after brief IV heparin had been negative except for minimal
atelectasis and rib fractures barely visible on posteroanterior view. The
delayed hemothorax had lowered the peripheral blood hematocrit to 23% and r
equired tube thoracostomy drainage and blood transfusion. The delayed traum
atic hemothorax in this case occurred on treatment with ticlopidine and did
not recur with continuation of aspirin alone.