Heart, lung & circulation
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Heart, lung & circulation · Jul 2016
Comparative StudyOut-of-hospital Cardiac Arrest Patient Characteristics: Comparing ventricular arrhythmia and Pulseless Electrical Activity.
The proportion of patients suffering out-of-hospital cardiac arrest presenting with ventricular arrhythmias/ventricular fibrillation (VT/VF) is decreasing, while the proportion presenting with pulseless electrical activity (PEA) is increasing. Cardiac arrest interventions target VT/VF and survival rates from PEA are much lower. The aim of this study was to compare clinical characteristics of those suffering PEA and VT/VF. ⋯ The population suffering PEA differs from the VT/VF cohort in a number of ways, and PEA is associated with significantly worse outcomes.
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Heart, lung & circulation · Jul 2016
Massive Pulmonary Embolism Mimicking Acute Myocardial Infarction: Successful use of extracorporeal membrane oxygenation support as bridge to diagnosis.
Prolonged cardiac arrest with pulseless electrical activity (PEA) results in death if its aetiology cannot be corrected immediately. We describe the case of a 75-year-old man with chest pain and his electrocardiogram (ECG) revealing ST-segment elevation in leads II, III, and aVf. Inferior wall myocardial infarction was subsequently diagnosed. ⋯ Subsequent pulmonary artery angiography showed severe emboli in bilateral branches of the pulmonary arteries. Catheter-directed thrombolysis with urokinase was administered, which ultimately failed, and surgical embolectomy was performed with extracorporeal membrane oxygenation support. After the above intervention, the patient was discharged on hospital day 60 without any sequelae or neurological deficits.