title: A 35-year-old pregnant woman presenting with sudden cardiac arrest secondary to peripartum cardiomyopathy.
abstract: We present a case of successful resuscitation from cardiac arrest after 25 minutes of ventricular fibrillation (VF) secondary to peripartum cardiomyopathy. This case highlights a rare disease, but also, more importantly, the successful use of the five links of survival: early access to 9-1-1, early cardiopulmonary resuscitation (CPR), early defibrillation, early advanced life support, and postresuscitative care. We also demonstrate the importance of high-quality resuscitation practices in order to achieve a successful outcome. Manual compressions can be performed at a guidelines-compliant rate. With training, users are able to achieve high compression fractions. Pre/post shock delays can be minimized to further increase compression fraction. Nationally, CPR interruptions are often long. We recommend closer attention to uninterrupted 2-minute cycles of CPR, minimizing delays in CPR through training, and a focus on a closely choreographed approach. User review of transthoracic impedance feedback data should play a vital role in a cardiac arrest quality-improvement program.
authors.affiliation: Redmond Fire Department-Medic One Division, King County, WA, USA. mnelson@redmond.gov
authors.forename: Matthew
authors.initials: M
authors.lastname: Nelson
authors.forename: Amy
authors.initials: A
authors.lastname: Moorhead
authors.forename: Dana
authors.initials: D
authors.lastname: Yost
authors.forename: Adrian
authors.initials: A
authors.lastname: Whorton
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000628:therapy; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002585:Cesarean Section; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004554:Electric Countershock; D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000628:therapy; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000628:therapy*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D018570:Risk Assessment; D014693:Ventricular Fibrillation / Q000150:complications / Q000175:diagnosis / Q000628:therapy