Cardiopulmonary bypass in revascularization and fluid management of exercise-induced acute myocardial infarction.
A 52-year-old man was resuscitated from a cardiac arrest during a marathon run. During initial evaluation, he received a significant amount of crystalloid fluid to maintain end-organ perfusion. Based on electrocardiogram findings, myocardial infarction was suspected and an angiogram was performed. An acute thrombosis of the left anterior descending vessel was noted, angioplastied, and stented. Given that he was in cardiogenic shock, acidotic, and hemodynamically labile, an emergent coronary artery bypass grafting with cardiopulmonary bypass was performed to simultaneously revascularize the myocardium and remove intravascular fluid.
Whitson
Bryan A
BA
Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
Nath
Dilip S
DS
Knudtson
Joshua R
JR
Shumway
Sara J
SJ
D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D000077324:Crystalloid Solutions; D003681:Dehydration / Q000150:complications / Q000628:therapy; D015444:Exercise; D005440:Fluid Therapy; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012420:Running
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions