The Drug-Induced Respiratory Disease Website

Anticoagulants, oral (vitamin K antagonists-VKA)

Esophageal hematoma (may cause chest pain and/or tracheal compression)

Xie X, Bai J, Li X

Massive intramural esophageal hematoma secondary to anticoagulation therapy for mitral valve replacement.

Journal of cardiac surgery 2016 Dec;31;740-741 — 2016 Dec — 740-741

Kumar V, Mallikarjuna HM, Gokulnath

A miniseries of spontaneous intramural esophageal hematoma in hemodialysis patients: a rare cause of dysphagia.

Hemodialysis international. International Symposium on Home Hemodialysis 2014 Apr;18;558-61 — 2014 Apr — 558-61

Cummins E, Sharkey M, Eastin T, Adkins E

A rare cause for acute chest pain in the emergency setting that is hard to swallow.

Case reports in emergency medicine 2013;2013;646342 — 2013 — 646342

Smart RF, Stone AR

Intramural oesophageal haematoma complicating anticoagulant therapy.

The New Zealand medical journal 1978 Mar 08;87;176-7 — 1978 Mar 08 — 176-7

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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