title: CPR-associated right ventricular rupture in the setting of pulmonary embolism.
abstract: Cardiopulmonary resuscitation (CPR) is an inherently traumatic procedure. Successful resuscitations are often complicated by iatrogenic injuries to structures of the neck, thorax, or abdomen. Rib and sternal fractures are the most frequently induced injuries. However, rare and life-threatening trauma to vital organs such as the heart may also occur during CPR. We describe a novel case of CPR-associated right ventricular rupture in a woman with acute-on-chronic pulmonary embolism and no known pre-existing cardiac disease. We propose that chest compressions in the setting of elevated right ventricular pressure resulted in cardiac rupture, in this case.
authors.affiliation: *Department of Pathology and Laboratory Medicine,Vancouver General Hospital,Vancouver,BC.
authors.forename: Tyler B M
authors.initials: TB
authors.lastname: Hickey
authors.affiliation: †Department of Emergency Medicine,Vancouver General Hospital,Vancouver,BC.
authors.forename: Ginjeet Gina K
authors.initials: GG
authors.lastname: Gill
authors.affiliation: ¶Department of Pathology,St. Paul's Hospital,Vancouver,BC.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Seidman
authors.affiliation: *Department of Pathology and Laboratory Medicine,Vancouver General Hospital,Vancouver,BC.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Webber
mesh_terms: D000368:Aged; D001344:Autopsy; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000379:methods; D004632:Emergency Medical Services; D017809:Fatal Outcome; D005260:Female; D015600:Glasgow Coma Scale; D006335:Heart Injuries / Q000209:etiology* / Q000473:pathology; D006336:Heart Massage / Q000009:adverse effects* / Q000379:methods; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*; D018570:Risk Assessment
keywords: autopsy; cardiac injury; iatrogenic; pulmonary embolism; resuscitation