Cardiac Thrombus Formation During Cardiopulmonary Resuscitation for Cardiac Arrest: Is It Time for...

Area of Science:

• Cardiology
• Critical Care Medicine
• Pathophysiology

Background:

• Current guidelines suggest thrombosis may cause cardiorespiratory arrest (CA).
• Cardiac thrombus formation (TF) is often considered a consequence, not a cause, of cardiac standstill.
• Infective endocarditis can lead to severe complications, including cardiac events.

Observation:

• A young male patient with infective endocarditis experienced sudden cardiac arrest (CA).
• During cardiopulmonary resuscitation (CPR), echocardiography revealed unexpected thrombus formation in the right atrium.
• The patient achieved return of spontaneous circulation after 16 minutes of CPR.

Findings:

• The cardiac thrombus resolved rapidly with intravenous heparin administration and continued chest compressions.
• This case challenges the traditional view of thrombosis as a primary cause of CA.
• Echocardiography played a crucial role in diagnosing and managing the cardiac thrombus during resuscitation.

Implications:

• Cardiac thrombus formation may be a consequence of circulatory arrest rather than a cause.
• Early recognition and treatment of cardiac thrombus during CPR can be life-saving.
• Cardiac ultrasound may prove valuable in managing cardiorespiratory arrest patients, despite not being routine.