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Multiple Systemic Embolization Associated with Chest Compression in a Patient with Cardiac Arrest
Kazuki Miyatani1, Ikuto Takeuchi1, Wataru Fujita1
1Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni, Japan.
Journal of Emergencies, Trauma, and Shock
|August 16, 2023
Summary
A massive left atrial thrombus caused cardiac arrest in an 80-year-old woman. Chest compressions scattered the thrombus, leading to systemic embolization and death, a unique complication of cardiopulmonary resuscitation.
Area of Science:
- Cardiology
- Neurology
- Emergency Medicine
Background:
- An 80-year-old female with a history of atrial fibrillation, heart failure, hypertension, and hyperlipidemia collapsed.
- She presented with cardiopulmonary arrest and was resuscitated after 12 minutes of basic life support.
Observation:
- The patient remained in a deep coma with atrial fibrillation-related tachycardia and signs of widespread ischemia.
- Imaging revealed multiple ischemic organs, suggesting a massive embolic event.
Findings:
- A large, free-floating thrombus originating from the left atrium likely caused left ventricular outflow tract obstruction and cardiac arrest.
- Chest compressions are hypothesized to have dispersed the thrombus, causing systemic embolization.
Implications:
- This case highlights a rare complication of chest compressions: systemic embolization from a pre-existing left atrial thrombus.
- It expands the known spectrum of complications associated with cardiopulmonary resuscitation in patients with atrial fibrillation.
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