Hemostatic instantaneous coagulation on echocardiogram: a defining feature of the last heartbeat (a case report)

Pan Afr Med J. 2022 May 5:42:7. doi: 10.11604/pamj.2022.42.7.34446. eCollection 2022.

Abstract

There is a paucity of detailed descriptions of echocardiographic features of the dying heart in the literature. A 64-year-old man on chronic hemodialysis presented with cardiac arrest after missing dialysis for three weeks. He received resuscitation efforts but died while his last heartbeats were fortuitously recorded by echocardiography. Rapid echo image acquisition during pulse check of a cardiopulmonary resuscitation attempt provided a unique opportunity for documenting the echocardiographic features of a dying heart. There was a rapid progressive dense echogenicity first in the left ventricular chamber and subsequently in all other chambers, which coincided with the final heartbeats. There is no prior documentation of this observation in the literature. We hereby illustrate and characterize this observation we term as Hemostatic Instantaneous Coagulation on Echo (HICE). HICE may be the defining feature of the dying heart and may guide the decision to discontinue resuscitation interventions.

Keywords: Echocardiography; cardiac arrest; case report; sinoventricular rhythm; spontaneous echo contrast.

Publication types

  • Case Reports

MeSH terms

  • Cardiopulmonary Resuscitation* / methods
  • Echocardiography
  • Heart Arrest* / etiology
  • Heart Arrest* / therapy
  • Heart Rate
  • Hemostatics*
  • Humans
  • Male
  • Middle Aged

Substances

  • Hemostatics