The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
Jan-Thorben Sieweke1, Jens Vogel-Claussen2, Andreas Martens3
1Cardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Abstract:
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.
Related Concept Videos
Cardiopulmonary Resuscitation I: Adult
Cardiopulmonary Resuscitation III: AED Use
Cardiopulmonary Resuscitation IV: Pharmacological Management
Cardiopulmonary Resuscitation II: ACLS Airway Management
Aortic Regurgitation I: Introduction
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques


