The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion

A 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventric...

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Main Authors: Jan-Thorben Sieweke, Jens Vogel-Claussen, Andreas Martens, Jörn Tongers, Andreas Schäfer, Johann Bauersachs, L. Christian Napp
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2018/1568491
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author Jan-Thorben Sieweke
Jens Vogel-Claussen
Andreas Martens
Jörn Tongers
Andreas Schäfer
Johann Bauersachs
L. Christian Napp
author_facet Jan-Thorben Sieweke
Jens Vogel-Claussen
Andreas Martens
Jörn Tongers
Andreas Schäfer
Johann Bauersachs
L. Christian Napp
author_sort Jan-Thorben Sieweke
collection DOAJ
description A 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventricle. Carotid pulses were present in the absence of femoral pulses. Subsequent computed tomography demonstrated inferior myocardial infarction with ventricular septal rupture and thrombotic occlusion of the thoracic aorta, resulting in a heart-brain-circulation with loss of perfusion downstream of the aortic arch. Teaching Points. The present case prototypically demonstrates the fatal consequence of acute ventricular septal rupture and the eminent value of computed tomography and palpation of carotid in addition to femoral pulses in resuscitated patients. It is, to the best of our knowledge, the first description of an acute aortic occlusion in a patient with acute ventricular septal rupture.
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publishDate 2018-01-01
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series Case Reports in Critical Care
spelling doaj-art-953967b73dbb441086af3ab19280e4ea2025-08-20T02:09:58ZengWileyCase Reports in Critical Care2090-64202090-64392018-01-01201810.1155/2018/15684911568491The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic OcclusionJan-Thorben Sieweke0Jens Vogel-Claussen1Andreas Martens2Jörn Tongers3Andreas Schäfer4Johann Bauersachs5L. Christian Napp6Cardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyInstitute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, GermanyDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, GermanyCardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyCardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyCardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyCardiac Arrest Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, GermanyA 66-year-old patient was admitted under continuous resuscitation for pulseless electrical activity. After return of spontaneous circulation ECG showed signs of acute inferior ST-elevation myocardial infarction, and echocardiography showed acute right ventricular failure with a dilated right ventricle. Carotid pulses were present in the absence of femoral pulses. Subsequent computed tomography demonstrated inferior myocardial infarction with ventricular septal rupture and thrombotic occlusion of the thoracic aorta, resulting in a heart-brain-circulation with loss of perfusion downstream of the aortic arch. Teaching Points. The present case prototypically demonstrates the fatal consequence of acute ventricular septal rupture and the eminent value of computed tomography and palpation of carotid in addition to femoral pulses in resuscitated patients. It is, to the best of our knowledge, the first description of an acute aortic occlusion in a patient with acute ventricular septal rupture.http://dx.doi.org/10.1155/2018/1568491
spellingShingle Jan-Thorben Sieweke
Jens Vogel-Claussen
Andreas Martens
Jörn Tongers
Andreas Schäfer
Johann Bauersachs
L. Christian Napp
The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
Case Reports in Critical Care
title The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
title_full The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
title_fullStr The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
title_full_unstemmed The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
title_short The No-Win Resuscitation: Ventricular Septal Rupture and Associated Acute Aortic Occlusion
title_sort no win resuscitation ventricular septal rupture and associated acute aortic occlusion
url http://dx.doi.org/10.1155/2018/1568491
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