Emergent bedside real-time three-dimensional transesophageal echocardiography in a patient with cardiac arrest following a caesarean section

Eur J Echocardiogr. 2011 Mar;12(3):E16. doi: 10.1093/ejechocard/jeq161. Epub 2010 Nov 1.

Abstract

Post-caesarean pulmonary embolism (PE) is associated with significant peri-operative morbidity and mortality. This report describes a case of sudden cardiac arrest 2 days post-caesarean due to massive PE diagnosed via bedside transesophageal echocardiography (TEE). Recognition of the PE at the bifurcation of the right and left pulmonary arteries was achieved by real-time three-dimensional TEE, but not two-dimensional TEE. Extracorporeal membrane oxygenation was immediately established and emergent pulmonary thromboembolectomy was performed. The patient was discharged without residual deficits on Day 22 of hospitalization.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Combined Modality Therapy
  • Echocardiography, Three-Dimensional* / methods
  • Echocardiography, Transesophageal / methods*
  • Emergencies
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Follow-Up Studies
  • Heart Arrest / diagnostic imaging*
  • Heart Arrest / etiology
  • Humans
  • Point-of-Care Systems*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / physiopathology
  • Pregnancy
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / therapy
  • Risk Assessment
  • Thrombectomy / methods
  • Treatment Outcome

Substances

  • Fibrinolytic Agents