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Right Atrial and Ventricular Collapse After Cardiopulmonary Resuscitation.

ABSTRACT: Prompt and effective chest compressions is the cornerstone cardiopulmonary resuscitation and has been found to improve cardiac arrest outcomes. Despite being rare, a wide variety of cardiac and pulmonary complications due to chest compressions have been identified. We present a case of a young, otherwise healthy female developing toxic shock syndrome and ultimately cardiac arrest requiring chest compressions found to cause right atrial and ventricular collapse on echocardiography.

SUBMITTER: Douedi S

PROVIDER: S-EPMC7868460 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Right Atrial and Ventricular Collapse After Cardiopulmonary Resuscitation.

Douedi Steven S Meleka Matthew M Daniels Steven S

Clinical Medicine Insights. Cardiology 20210201

Prompt and effective chest compressions is the cornerstone cardiopulmonary resuscitation and has been found to improve cardiac arrest outcomes. Despite being rare, a wide variety of cardiac and pulmonary complications due to chest compressions have been identified. We present a case of a young, otherwise healthy female developing toxic shock syndrome and ultimately cardiac arrest requiring chest compressions found to cause right atrial and ventricular collapse on echocardiography. ...[more]

PMID: 33613036

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Project description:BACKGROUND:Few studies have reported left ventricular wall findings in contrast-enhanced computed tomography (CE-CT) after extracorporeal cardiopulmonary resuscitation (ECPR). This study examined left ventricular wall CE-CT findings after ECPR and evaluated the association between these findings and the results of coronary angiography and prognosis. METHODS:We evaluated out-of-hospital cardiac arrest patients who were treated with ECPR and subsequently underwent both non-electrocardiography-gated CE-CT and coronary angiography at our center between January 2011 and April 2018. Left ventricular wall CE-CT findings were classified as follows: (1) homogeneously enhanced (HE; the left ventricular wall was homogeneously enhanced), (2) segmental defect (SD; the left ventricular wall was not segmentally enhanced according to the coronary artery territory), (3) total defect (TD; the entire left ventricular wall was not enhanced), and (4) others. Successful weaning from extracorporeal membrane oxygenation, survival to hospital discharge, and predictive ability of significant stenosis on coronary angiography were compared among patients with HE, SD, and TD patterns. RESULTS:A total of 74 patients (median age, 59?years) were eligible, 50 (68%) of whom had initial shockable rhythm. Twenty-three (31%) patients survived to hospital discharge. HE, SD, TD, and other patterns were observed in 19, 33, 11, and 11 patients, respectively. The rates of successful weaning from extracorporeal membrane oxygenation (84% vs. 39% vs. 9%, p?<?0.01) and survival to hospital discharge (47% vs. 27% vs. 0%, p?=?0.02) were significantly different among patients with HE, SD, and TD patterns. In post hoc analysis, patients with HE patterns had a significantly higher success rate of weaning from extracorporeal membrane oxygenation than those with SD and TD patterns. SD predicted significant stenosis with a sensitivity of 74% and specificity of 94%. CONCLUSIONS:Homogenously enhanced left ventricular wall might be a predictor of good left ventricular function recovery. In contrast, total enhancement defect in the entire left ventricular wall was associated with poor outcomes. Contrast defect matching the coronary artery territory could predict significant coronary artery stenosis with good specificity. The left ventricular wall findings in non-electrocardiography-gated CE-CT after ECPR might be useful for diagnosis and prognostic prediction.

Dataset Information

Right Atrial and Ventricular Collapse After Cardiopulmonary Resuscitation.

Publications

Right Atrial and Ventricular Collapse After Cardiopulmonary Resuscitation.

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