Acute Crit Care.  2019 Aug;34(3):228-231. 10.4266/acc.2015.00633.

Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury

Affiliations
  • 1Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
  • 2Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. shwang@yonsei.ac.kr

Abstract

There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.

Keyword

cardiopulmonary resuscitation; heart arrest; thoracic aortic aneurysm

MeSH Terms

Airway Obstruction
Aorta, Thoracic
Aortic Aneurysm, Thoracic
Cardiac Tamponade
Cardiopulmonary Resuscitation*
Echocardiography*
Echocardiography, Transesophageal
Emergency Service, Hospital
Follow-Up Studies
Heart Arrest
Hemorrhage
Humans
Middle Aged
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