Emergent bedside real-time three-dimensional transesophageal echocardiography in a patient with cardiac arrest following a caesarean section.
Post-caesarean pulmonary embolism (PE) is associated with significant peri-operative morbidity and mortality. This report describes a case of sudden cardiac arrest 2 days post-caesarean due to massive PE diagnosed via bedside transesophageal echocardiography (TEE). Recognition of the PE at the bifurcation of the right and left pulmonary arteries was achieved by real-time three-dimensional TEE, but not two-dimensional TEE. Extracorporeal membrane oxygenation was immediately established and emergent pulmonary thromboembolectomy was performed. The patient was discharged without residual deficits on Day 22 of hospitalization.
Cardiovascular Center, Cheng-Hsin General Hospital, Taipei, Taiwan.
Jeng
J
Wei
Hou-Sheng
HS
Yang
Shen Kou
SK
Tsai
Ming C
MC
Hsiung
Chung-Yi
CY
Chang
Ching-Huei
CH
Ou
Yi Cheng
YC
Chang
Kuo Chen
KC
Lee
Sung-How
SH
Sue
Yi-Pen
YP
Chou
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D003131:Combined Modality Therapy; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004630:Emergencies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D019095:Point-of-Care Systems; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D018570:Risk Assessment; D017131:Thrombectomy / Q000379:methods; D016896:Treatment Outcome
D005343:Fibrinolytic Agents