[A young woman with cardiac arrest].
A 20-year-old woman presented with dyspnoea in the Emergency department and subsequently suffered a cardiac arrest. The initial rhythm was PEA (pulseless electrical activity). She had intermittent return of spontaneous circulation. Transthoracic echocardiography showed a dilated hypokinetic right ventricle and a collapsed left ventricle. The tentative diagnosis was pulmonary embolism, but she remained hemodynamically unstable despite thrombolysis. 90 min after the collapse she was put on cardiopulmonary bypass and surgical embolectomy was performed. Large masses of thrombotic material were collected from central parts of the right and left pulmonary artery. Therapeutic hypothermia was applied for 24 hours postoperatively. The remaining hospital stay was uneventful and ten days after the presentation she was transferred to her local hospital. At this point she was without neurological sequelae. The patient had used oral contraceptives (ethinyl estradiol/ drospirenone).
Vanke
Petter
P
Klinikk for hjertemedisin, St. Olavs hospital, Universitetssykehuset i Trondheim, 7030 Trondheim, Norway. petter.vanke@gmail.com
Nordseth
Trond
T
Loennechen
Jan P
JP
Mostad
Dagmar Heinke
DH
Skjaerpe
Terje
T
Sellevold
Olav F M
OF
D016887:Cardiopulmonary Resuscitation; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D017128:Embolectomy; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006355:Heart-Lung Machine; D006801:Humans; D007036:Hypothermia, Induced; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D055815:Young Adult
D003277:Contraceptives, Oral, Combined; D004997:Ethinyl Estradiol