CPR-associated right ventricular rupture in the setting of pulmonary embolism

CJEM. 2016 Nov;18(6):484-487. doi: 10.1017/cem.2016.327. Epub 2016 May 16.

Abstract

Cardiopulmonary resuscitation (CPR) is an inherently traumatic procedure. Successful resuscitations are often complicated by iatrogenic injuries to structures of the neck, thorax, or abdomen. Rib and sternal fractures are the most frequently induced injuries. However, rare and life-threatening trauma to vital organs such as the heart may also occur during CPR. We describe a novel case of CPR-associated right ventricular rupture in a woman with acute-on-chronic pulmonary embolism and no known pre-existing cardiac disease. We propose that chest compressions in the setting of elevated right ventricular pressure resulted in cardiac rupture, in this case.

Keywords: autopsy; cardiac injury; iatrogenic; pulmonary embolism; resuscitation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autopsy
  • Cardiopulmonary Resuscitation / adverse effects*
  • Cardiopulmonary Resuscitation / methods
  • Emergency Medical Services
  • Fatal Outcome
  • Female
  • Glasgow Coma Scale
  • Heart Injuries / etiology*
  • Heart Injuries / pathology
  • Heart Massage / adverse effects*
  • Heart Massage / methods
  • Heart Ventricles / injuries
  • Humans
  • Out-of-Hospital Cardiac Arrest / complications
  • Out-of-Hospital Cardiac Arrest / diagnosis
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis*
  • Risk Assessment