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BACKGROUND Essential thrombocythemia (ET) is a risk factor both for bleeding caused by abnormal platelet function and for thrombus formation caused by excessive platelet proliferation. We present a rare case of alveolar hemorrhage after dual antiplatelet therapy (DAPT), a serious bleeding complication of antithrombotic therapy, in a patient with an acute myocardial infarction complicated by ET. CASE REPORT A 75-year-old man was treated for ET. He experienced an acute myocardial infarction, and an emergent percutaneous coronary interventi