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Case Report
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Korean J Med. 2015;88(4):434-437. Published online April 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.4.434
- 심정지 이후에 장시간 시행된 흉부압박에 의해 발생한 우심실 파열 1예
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이희정1, 권성순1, 강혜란1, 방덕원1, 박병원1, 이민호1, 장원호2
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1순천향대학교 의과대학 순천향대학교 서울병원 내과
2순천향대학교 의과대학 순천향대학교 서울병원 흉부외과
- Right Ventricular Rupture Caused by Prolonged Cardiopulmonary Resuscitation after Sudden Cardiac Arrest
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Hee Jeong Lee1, Seong Soon Kwon1, Hye Ran Kang1, Duk Won Bang1, Byoung Won Park1, Min-Ho Lee1, Won-Ho Chang2
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1Departments of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
2Departments of Cardiovascular and Thoracic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Corresponding author: Duk Won Bang ,Tel: +82-2-709-3082, Fax: +82-2-790-2313, Email: schbdw@schmc.ac.kr
- Received: August 11, 2014; Revised: September 18, 2014 Accepted: September 26, 2014.
- 원인이 명확하지 않은 46세 급성 심장정지 환자에서 2시간 이상의 흉부압박을 시행 후 자발 순환 회복되었으나 설명되지 않는 지속적 저혈압을 보여 반복적인 심초음파를 시행하였고, 심낭압전 및 혈심낭이 확인되어 진단적 개흉술로 우심실벽 파열을 진단한 환자를 경험하여 보고하는 바이다.
߽ɾ :심장 파열; 심장마사지; 심폐소생술
- Abstract
- A 46-year-old male arrived at the emergency department with acute dyspnea. On the way to the hospital, heart massage was performed in the ambulance due to asystole on electrocardiography. After 2 hr of resuscitation, sinus rhythm was restored. Extracorporeal life support and an intra-aortic balloon pump were applied due to cardiogenic shock, but the patient showed sustained hypotension. Echocardiography showed moderate pericardial effusion with physiological evidence of cardiac tamponade; emergency pericardiocentesis was performed, which produced bloody pericardial fluid. An explorative sternotomy revealed a massive hematoma in the mediastinum and right ventricular (RV) free wall rupture. After primary repair, echocardiography showed improved left ventricular systolic function and the patient was stable clinically. This case presents RV free wall rupture as an unusual complication of prolonged heart massage. Heart rupture should be considered in hemodynamically unstable patients after prolonged heart massage.
Keywords :Heart rupture, Heart massage, Cardiopulmonary resuscitation
