The American journal of emergency medicine
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Emergency medicine dogma traditionally teaches that aortic dissection presents as tearing chest pain, radiating to the back. This case report describes a 55-year-old woman presenting with a left homonymous hemianopsia and resultant gait disturbance. ⋯ This report provides further evidence for atypical, painless presentations of aortic dissection. Given recent literature on the increasing prevalence of painless dissection, the disease entity should be included in the differential diagnosis for stroke, and a simple portable chest x-ray should always be obtained before administering thrombolytics.
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Extracorporeal membrane oxygenation (ECMO) is a form of a mechanical cardiopulmonary life-support system and an adjunct to prolonged cardiac resuscitation. The ECMO results in good outcomes for patients with in-hospital cardiac arrest. ⋯ Cardiac arrest with ventricular fibrillation was refractory to conventional cardiopulmonary resuscitation. In this case, the ECMO–cardiopulmonary resuscitation provided cardiopulmonary life support for out-of-hospital cardiac arrest, achieving a sustained return of spontaneous circulation that allowed prompt percutaneous coronary intervention and a good recovery.
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Hypereosinophilic syndromes are rare diseases; however, cardiac involvement is frequently seen. When diagnosed promptly, the prognosis is relatively good; however, a final diagnosis is made by ruling out many conditions leading to secondary eosinophilia. We present a case of Loeffler's endomyocarditis primarily misdiagnosed as an acute coronary syndrome, complicated by low output heart failure and cardiac arrest. After hypereosinophilic syndrome was confirmed and treatment with prednisone initiated, the patient responded well to therapy, and her further recovery was complete and uneventful.
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Comparative Study
The effects of 3 different compression methods on intrathoracic pressure in a swine model of ventricular fibrillation.
The aim of this study was to provide a realistic comparison of 3 different extracorporeal compression methods during cardiopulmonary resuscitation on intrathoracic pressure (ITP), hemodynamics, and oxygen metabolism in a swine model of ventricular fibrillation (VF). ⋯ Mechanical compression cannot replace traditional artificial manual compression, which remains the preferred method for cardiopulmonary resuscitation.