The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion

A 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventric...

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Published inCase Reports in Critical Care Vol. 2018; no. 2018; pp. 1 - 4
Main Authors Napp, L. C., Schäfer, A., Tongers, Jörn, Martens, Andreas, Vogel-Claussen, Jens, Sieweke, Jan-Thorben, Bauersachs, J.
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 2018
Hindawi
John Wiley & Sons, Inc
Wiley
Subjects
Case Report
CT imaging
Electrocardiogram
Electrocardiography
Heart
Heart attack
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Summary:A 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventricle. Carotid pulses were present in the absence of femoral pulses. Subsequent computed tomography demonstrated inferior myocardial infarction with ventricular septal rupture and thrombotic occlusion of the thoracic aorta, resulting in a heart-brain-circulation with loss of perfusion downstream of the aortic arch. Teaching Points. The present case prototypically demonstrates the fatal consequence of acute ventricular septal rupture and the eminent value of computed tomography and palpation of carotid in addition to femoral pulses in resuscitated patients. It is, to the best of our knowledge, the first description of an acute aortic occlusion in a patient with acute ventricular septal rupture.
Bibliography:Academic Editor: Chiara Lazzeri
ISSN:2090-6420
2090-6439
DOI:10.1155/2018/1568491