Massive hemothorax following failed internal jugular vein access during an electrophysiological procedure: "Early detection - catastrophe averted"

We report an unusual case of massive hemothorax in a female patient undergoing electrophysiological (EP) procedure for drug-refractory supraventricular tachycardia. She underwent percutaneous intervention with a drug-eluting stent to the right coronary artery 6 months back and was on dual antiplatelet drugs. Timely detection and management of hemothorax prevented a major catastrophe in this patient. This case highlights the importance of keeping a strict vigil for possible occurrence of life-threatening bleeding complications during EP procedure in patients on multiple antiplatelet drug therapy.