Background Diffuse alveolar hemorrhage is a medical emergency caused by persistent and recurrent pulmonary hemorrhage [ 1 ]. It is an uncommon presentation of polymyositis. Symptoms of polymyositis include fatigue, muscle pains, proximal muscle weakness, and joint pains [ 2 ]. Case presentation A 44-year-old male presented with new onset shortness of breath and productive cough with white sputum and occasional hemoptysis. The patient was diagnosed with diffuse alveolar hemorrhage (DAH) via bronchoscopy and discharged initially on prednisone. The patient's laboratory work indicated positive titers of ANA & anti-Jo-1 antibody with low complement levels. These results pointed towards the diagnosis of polymyositis [ 3 ]. DAH can also be caused by systemic lupus erythematosus, Goodpasture's syndrome, Sjogren syndrome, anticoagulant therapy, and antiphospholipid antibody syndrome [4]. However, the possibility of these potential causes was excluded. Conclusion This case of diffuse alveolar hemorrhage was most likely due to polymyositis.

Cardiopulmonary resuscitation (CPR) is a life-saving medical procedure used in the setting of cessation of cardiac and respiratory function of a patient to maintain vital functions. CPR was developed in the 1950s as mouth to mouth resuscitation. Defibrillation, chest compression and ventilation were added to CPR in 1960. Chest compressions are thought to be the most important aspect of CPR and adequate performance of chest compression is required for successful resuscitation as emphasized in recent guidelines. However, chest compressions may be a source of injury to ribs, sternum, spleen, stomach, or liver. We present a case of a 30-year-old female with end-stage renal disease, hypertension, polysubstance abuse, and GERD who underwent CPR resulting in a grade 4 liver laceration. The new guidelines of Advanced Cardiac Life Support emphasize the need of regular forceful chest compressions during CPR which, although required for proper resuscitation of the patient may result in significant injuries to the viscera as seen in this patient. The aim of this case report is to highlight the possible complications of CPR and its long-term consequences.

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