Case Report- An 80 year old woman with pleuritic chest pain and dysphagia

The aim of this study is to describe a case of hemomediastinum in a patient being treated with warfarin for pulmonary thromboembolism; in order to facilitate diagnosis and clinical management of patients suffering from this rare but life-threatening complication.An 80-year-old patient was admitted to Intensive Care Unit of Dr. Masih Daneshvari hospital, Shahid Beheshti Medical University due to pleuritic chest pain, dyspnea and dysphagia. The Patient's laboratory results showed anemia and an INR >8 and which was corrected by infusion of fresh frozen plasma. The aspiration of evident pleural fluid on chest radiograph, showed hemothorax. Mediastinal widening was assessed by chest CT-scan which denoted on a mediastinal hematoma. There was no other site of bleeding. Symptoms subsided with supportive care and correction of coagulopathy.Non-traumatic mediastinal hemorrhage is a rare and potentially life-threatening complication of anticoagulant therapy which must be taken into consideration even in the absence of symptoms of overt bleeding.