title: Cardiac Arrest as a Consequence of Air Embolism: A Case Report and Literature Review.
abstract: Air embolism is an infrequent but potentially catastrophic complication. It could be a complication of invasive procedures including surgery, central line placement, positive pressure ventilation, trauma, hemodialysis, pacemaker placement, cardiac ablation, and decompression sickness. Usually, it does not cause any hemodynamic complication. In rare cases, it could lodge in the heart and cause cardiac arrest. We present a case of an 82-year-old white female who underwent computed tomography (CT) guided biopsy of right lung pulmonary nodule. When she was turned over after the lung biopsy, she became unresponsive and developed cardiopulmonary arrest. She underwent successful resuscitation and ultimately was intubated. CT chest was performed immediately after resuscitation which showed frothy air dense material in the left atrium and one of the right pulmonary veins suggesting a Broncho venous fistula with air embolism. Although very rare, air embolism could be catastrophic resulting in cardiac arrest. Supportive care including mechanical ventilation, vasopressors, volume resuscitation, and supplemental oxygen is the initial management. Patients with cardiac, neurological, or respiratory complications benefit from hyperbaric oxygen therapy.
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Zia Ur
authors.initials: ZU
authors.lastname: Rahman
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Ghulam
authors.identifier: 0000-0001-9661-5373
authors.initials: G
authors.lastname: Murtaza
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Pourmorteza
authors.affiliation: Blue Ridge Pulmonary Associates, Kingsport, TN, USA.
authors.forename: Wael K
authors.initials: WK
authors.lastname: El Minaoui
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Sethi
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Peyman
authors.initials: P
authors.lastname: Mamdouhi
authors.affiliation: Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Timir
authors.identifier: 0000-0001-7766-6714
authors.initials: T
authors.lastname: Paul