The Drug-Induced Respiratory Disease Website

Anticoagulants, direct oral (anti-thrombin, -IIa, -Xa) - NOAC

Hemopericardium - Bloody pericardial effusion

Large effusions can cause cardiac tamponade. May occur late into treatment with anticoagulants

Asad ZUA, Ijaz SH, Chaudhary AMD, Khan SU, Pakala A

Hemorrhagic cardiac tamponade associated with Apixaban: A case report and systematic review of literature.

Cardiovascular revascularization medicine : including molecular interventions 2019 Apr 04;; — 2019 Apr 04

Kham NM, Song M

Spontaneous, Life-Threatening Hemorrhagic Cardiac Tamponade Secondary to Rivaroxaban.

American journal of therapeutics 2016 Jul-Aug;23;e1128-31 — 2016 Jul-Aug — e1128-31

Shivamurthy P, Brar N, Therrien ML

Isolated hemopericardium associated with rivaroxaban: first case report.

Pharmacotherapy 2014 Sep;34;e169-72 — 2014 Sep — e169-72

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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