Unusual dyspnea in a hemodialysis patient: A case report

Dyspnea in a hemodialysis patient

  • Ching-Hsiang Wang
  • Jenq-Shyong Chan
  • Chung-Chi Yang
  • Po-Jen Hsiao


The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy.


1. Patrini D, Panagiotopoulos N, Pararajasingham J, et al. Etiology and management of spontaneous haemothorax. J Thorac Dis. 2015 Mar; 7(3): 520-6.
2. Camarillo-Reyes LA, Marquez-Córdova RI, Surani S, et al. Hemothorax induced by severe cough: An unusual presentation. SAGE Open Med Case Rep. 2019 Apr 26; 7: 2050313X19846043.
3. Yen CW, Hsu LS, Chen CW, et al. Hepatocellular carcinoma with thoracic metastases presenting as hemothorax: A case report and literature review. Medicine (Baltimore). 2018 Jun; 97(22): e10945.
4. Fan J, Feng R, Hou X, et al. IgG4-related disease can present as recurrent spontaneous hemothorax: a case report. BMC Pulm Med. 2019 Feb 1; 19(1): 26.
5. Li PS, Tsai CL, Hu SY, et al. Spontaneous hemothorax caused by ruptured multiple mycotic aortic aneurysms: a case report and literature review. J Cardiothorac Surg. 2017 Dec 2; 12(1): 109.
6. Marcel Rodriguez-Guzman, Belen Gallegos-Carrera, Sara Vicente-Antunes, et al. Spontaneous Hemothorax in a Patient With von Recklinghausen's Disease. J Clin Med Res. 2014 Apr; 6(2): 149-52.
7. Tong YL, Lu YQ, Jiang JK, et al. Spontaneous rupture of the branches of left subclavian artery: A case report and review of the literatures. Medicine (Baltimore). 2018 Apr; 97(14): e0290.
How to Cite
WANG, Ching-Hsiang et al. Unusual dyspnea in a hemodialysis patient: A case report. International Archives of Medicine, [S.l.], v. 12, june 2019. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2888>. Date accessed: 20 july 2019. doi: https://doi.org/10.3823/2607.

Most read articles by the same author(s)