Ruptured pulmonary infarction: A rare, fatal complication of thromboembolic disease

We describe 2 men, ages 69 and 49 years, who experienced fatal rupture of p ulmonary infarcts, Both patients had documented Drier thromboembolic events and subsequently had abrupt deterioration in cardiorespiratory function. A utopsies showed massive unilateral hemothorax in both patients, Rupture of a pulmonary infarct may occur spontaneously or iatrogenically due to aggres sive anticoagulation, This may be difficult to distinguish from secondary h emothorax with an intact pleura, but rupture typically has a considerably m ore rapid clinical evolution, Treatment should include immediate withdrawal of thrombolytic or anticoagulant medications and evacuation of the pleural space. Surgical intervention can be considered, although the utility of th at approach must await prospective trials.