Aortoesophageal fistula due to a penetrating aortic ulcer.

et al. reported that their patient had elevated pulmonary capillary wedge pressure at the time of catheterization. In addition, Sitges et al8 reported a case of pulmonary hemorrhage following abciximab use who had radiographic evidence of pulmonary congestion before administration. This probable correlation was also supported by Khanlou et al,9 who reported 6 patients with pulmonary hemorrhage following abciximab use, 5 of whom had elevated pulmonary capillary wedge pressures. Although the small number precluded any definitive comments, pulmonary congestion or elevated pressures in the pulmonary bed in patients who receive glycoprotein IIb-IIIa inhibitors may predispose patients to alveolar hemorrhage. Since, the radiographic features of diffuse alveolar hemorrhage strinkingly resemble cardiogenic pulmonary congestion, we think that before administration of these agents, a radiographic examination may help us to diffentiate the high risk group for this life-threatening complication.