Severe Bleeding Tendency due to Excessive Fibrinolysis in Two Patients With Aortic Disease: Role of Tranexamic Acid in Non-Surgical Candidate

Abstract

Disseminated intravascular coagulation (DIC) is characterized by systemic activation of coagulation pathway which can lead to thrombosis and bleeding. Chronic DIC associated with aortic aneurysm or dissection commonly presents with bleeding symptoms with variable severity due to enhanced fibrinolysis. Patients with unexplained bleeding diathesis with DIC should include aortic disease as one of the differential diagnoses. This paper reports two patients with severe hemorrhagic complications due to aortic disease. Long-term prophylactic treatment is recommended if the underlying aortic disease cannot be surgically managed. Tranexamic acid is a potentially safe option to relieve bleeding tendency. J Med Cases. 2020;11(10):303-305 doi: https://doi.org/10.14740/jmc3549