Subclavian vein puncture-induced massive pulmonary hemorrhage and hemoptysis during pacemaker implantation

Abstract

We present a rare and interesting case of subclavian vein puncture-induced focal intraparenchymal lung hemorrhage andmassive hemoptysis developed during CRT-D implantation. Clinical picture advanced to pulmonary edema in seconds. Anoncontrast multiple-detector computed tomography scan revealed focal alveolar hemorrhage in the lung tissue right underthe pacemaker pocket, but remarkably, there was no pneumothorax. This case shows that if cough and hemoptysis suddenlydevelop during subclavian puncture, injury of the adjoining lung because of parenchymal puncture should be considered asa complication.