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KMID : 1144420190340030228
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Acute and Critical Care
2019 Volume.34 No. 3 p.228 ~ p.231
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Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury
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Lee Dong-Keon
Kang Kyung-Sik
Cha Yong-Sung
Cha Kyoung-Chul
Kim Hyun
Lee Kang-Hyun
Hwang Sung-Oh
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Abstract
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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.
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KEYWORD
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aortic aneurysm, thoracic, cardiopulmonary resuscitation, heart arrest
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