Acute aortic dissection developed after cardiopulmonary resuscitation: transesophageal echocardiographic observations and proposed mechanism of injury.

Abstract

There has been no report about aortic dissection due to cardiopulmonary resuscitation (CPR). We present here a case of acute aortic dissection as a rare complication of CPR and propose the potential mechanism of injury on the basis of transesophageal echocardiographic observations. A 54-year-old man presented with cardiac arrest after choking and received 19 minutes of CPR in the emergency department. Transesophageal echocardiography (TEE) during CPR revealed a focal separation of the intimal layer at the descending thoracic aorta without evidence of aortic dissection. After restoration of spontaneous circulation, hemorrhagic cardiac tamponade developed. Follow-up TEE to investigate the cause of cardiac tamponade revealed aortic dissection of the descending thoracic aorta. Hemorrhagic cardiac tamponade was thought to be caused by myocardial hemorrhage from CPR.

• Authors: Dong Keon Lee, Kyung Sik Kang, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
• Journal: Acute and critical care (Acute Crit Care) Vol. 34 Issue 3 Pg. 228-231 (Aug 2019) ISSN: 2586-6060 [Electronic] Korea (South)
• PMID: 31723934 (Publication Type: Case Reports)
• Copyright: Copyright © 2019 The Korean Society of Critical Care Medicine.