Cerebral and coronary air embolism: an intradepartmental suicide attempt.
Uncooperative but alert on arrival, a 21-year-old suicidal man was found suddenly unconscious with agonal respirations 2 h into his Emergency Department evaluation. Initially admitted for ingesting multiple pills and self-inflicting a deep wrist laceration, the patient now had a Glasgow Coma Scale score of 3, a dense left-sided hemiplegia, and an electrocardiogram suggestive of acute myocardial infarction. This constellation of physical findings, together with an echocardiogram revealing bi-ventricular gas artifact, led to a diagnosis of coronary and cerebral air emboli. The patient was urgently resuscitated and then underwent hyperbaric oxygen therapy. Subsequent examination confirmed a full recovery. This article details this unprecedented case, as well as clinically relevant aspects of air embolism.
Doostan
David K
DK
Department of Emergency Medicine, Alameda County Medical Center, Highland Hospital, 1411 E. 31st Street, Oakland, CA 94602, USA.
Steffenson
Sandra L
SL
Snoey
Eric R
ER
D000328:Adult; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004452:Echocardiography; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004636:Emergency Service, Hospital; D006429:Hemiplegia / Q000209:etiology / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000628:therapy; D013406:Suicide, Attempted; D016896:Treatment Outcome