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At least 433 records · Page 24Linked to original sources
PubMed1996

[Heart arrest during dipyridamole scintigraphy: report of 3 cases].

Potentially life threatening rythm disturbances, such as third degree A-V block and sinus arrest without "escape rythm", represent infrequent and unexpected events during dipyridamole thallium scintigraphy. We report three cases of cardiac arrest requiring resuscitation maneuvers after dipyridamole infusion during myocardial thallium scan. On the basis of these clinical observations we suggest that a trained cardiologist and resuscitation kit should be available in nuclear lab. Moreover elderly patients may require careful screening for preexisting conduction defects and sick sinus syndrome. When dipyridamole infusion provokes severe bradyarrhythmias not related to myocardial ischemia, a transesophageal electrophysiological study should always be performed.

Aged↗
PubMedDate not supplied

[Heart arrest caused by CO2 embolism during a laparoscopic cholecystectomy].

A 41-year-old woman developed a gas embolism while inserting a Veress needle to achieve pneumoperitoneum for laparoscopic cholecystectomy. The embolism led to asystole, which was corrected after advanced cardiopulmonary resuscitation maneuvers, and was followed by sequelae and a prolonged hospital stay. The anesthesiologist should be vigilant during laparoscopic surgery and be ready and able to act in case of major complications.

Adult↗
PubMed1994

[Heart arrest: septic and hypovolemic shock--intraosseous infusion technique].

Cardiorespiratory arrests in infants are most often caused by generalized hypoxia. This leads to the well-known fact that the outcome of arrests in the pediatric age group is poor. On the other hand we have the chance to recognize the ongoing hypoxia at early stages. Prevention of this dangerous situation is the aim of treatment. Clinical manifestations of shock states in children differ considerably from those seen in adult patients. Causes and treatment of hypovolemic and septic shock and the technique of intraosseous puncture and infusion are described in detail.

Child, Preschool↗
PubMed2000

[Heart arrest caused by ventricular fibrillation in acute biliary pancreatitis: a case report and etiopathogenetic hypothesis].

Acute pancreatitis and/or gallbladder disease precipitating angina pectoris, or producing arrhythmias or ST-T wave changes on electrocardiography in the absence of coronary artery disease, have frequently been mentioned. Many attempts have been made to explain the etiology of these findings. To the authors' knowledge, this report is the most dramatic expression of pathogenetic mechanisms which are still considered hypothetical.

Acute Disease↗
PubMed1993

[Bronchospasm, apnea and heart arrest following dipyridamole perfusion scintigraphy].

The occurrence of fatal respiratory insufficiency following dipyridamole-thallium imaging is described. The patient, a 67-year-old man, had a history of chronic obstructive lung disease. Since patients with a history of chronic obstructive lung disease have an increased risk of developing bronchospasm after dipyridamole infusion, it is advised to be cautious in performing dipyridamole-thallium imaging in these patients. Dobutamine may be an acceptable alternative to dipyridamole in these patients.

Aged↗
PubMed1984

[Heart arrest in gastroscopy--report of 2 cases].

Two cases with cardiac arrest in the early phase of gastroscopy are presented. In a 83-years-old patient, the external cardiac reanimation was successful, but nevertheless the cardiac intensive therapy a 85-years-old woman died. The possible causes of cardiac complications of gastroscopy are discussed and consequences for premedication are proposed. This first communication about a fatal complication during gastroscopy in the GDR is reported to emphasize the potential rare but serious dangers of gastroscopy.

Aged↗
PubMed2002

Myocardial interstitial glucose and lactate before, during, and after cardioplegic heart arrest.

The interstitial fluid of the human myocardium was monitored in 13 patients undergoing aortic valve and/or bypass surgery before, during, and after hypothermic potassium cardioplegia. The regulation of glucose and lactate was studied after sampling with microdialysis. The following questions were addressed. 1). Is the rate of transcapillary diffusion the limiting step for myocardial uptake of glucose before or after cardioplegia? 2). Does cold potassium cardioplegia induce a critical deprivation of glucose and/or accumulation of lactate in the myocardium? Before cardioplegia, interstitial glucose was approximately 50% of the plasma level (P < 0.001). Interstitial glucose decreased significantly immediately after induction of cardioplegia and remained low (1.25 +/- 0.25 mM) throughout cardioplegia. It was restored to precardioplegic levels 1 h after release of the aortic clamp. Interstitial glucose then decreased again at 25 and 35 h postoperatively to the levels observed during cardioplegia. Interstitial lactate decreased immediately after induction of cardioplegia but returned to basal level during the clamping period. At 25 and 35 h, interstitial lactate was significantly lower than before and during cardioplegia. Glucose transport over the capillary endothelium is considered rate limiting for its uptake in the working heart but not during cold potassium cardioplegia despite the glucose deprivation following perfusion of glucose-free cardioplegic solution. Lactate accumulated during cardioplegia but never reached exceedingly high interstitial levels. We conclude that microdialysis provides information that may be relevant for myocardial protection during open-heart surgery.

Adult↗
PubMed2004

[Heart arrest: which reality and which training for the practitioner?].

Sudden death related to out-of hospital cardiac arrest is an important cause of mortality, which is mainly caused by ventricular fibrillation, a potentially reversible condition. The prognosis of out-of-hospital cardiac arrest remains dismal despite well developed emergency medical services. Witnessed arrest, ventricular fibrillation as the initial arrhythmia, cardiopulmonary resuscitation and early defibrillation are systematically associated with better survival. Key interventions must therefore be enforced to improve survival from out-of-hospital cardiac, introducing the concept of a "chain of survivals". The aim of the present article, which is illustrated by local results, is to review this important public health issue, to emphasize the role of the general practitioner in the chain of survival, and to promote education and training of basic and advanced life support.

Family Practice↗
PubMed1990

[Coronary vasospasm: a cause of sudden death. Case report of reversible heart arrest with spontaneous coronary spasm documented by angiography].

The authors report a case of cardiac arrest occurring in a patient who had just entered the catheter laboratory for coronary angioplasty. Opacification of the left coronary artery revealed a proximal occluding double spasm unrelated to the distal stenoses for which angioplasty had been requested. Resuscitation and antispastic therapy with intracoronary injection of a nitrate derivative resulted in a complete recovery without any sequellae. The role of coronary spasm in sudden death and the value of the ergometrine test in patients with coronary stenosis are discussed.

Coronary Angiography↗
PubMed1989

[Coronary artery spasm as a rare cause of sudden heart arrest].

After successful resuscitation only few patients present without any findings indicative of the causes of their cardiac arrest. We report on a 39-year-old woman who had normal clinical, electrocardiographic, and angiographic findings after she was successfully resuscitated. In contrast to other patients without apparent organic heart disease she had three cardiac arrests within 10 months; each episode was preceded by an ascending epigastric pain. During an attack with epigastric pain a long-term ECG recording documented an increasing ST-segment elevation followed by rapid, non-sustained ventricular tachycardia. Intravenous ergonovine induced a spasm of the right coronary artery with a subtotal vessel occlusion and an ST-elevation in lead III. After medication with a calcium antagonist no coronary vasospasm was demonstrated. For 11 months the patient has been without any complaints.

Coronary Angiography↗
PubMed2003

[Bolus injection of recombinant tissue-type plasminogen activator during cardiopulmonary resuscitation in massive pulmonary embolism complicated with heart arrest. Report of 2 cases and review of the literature].

In the early phase of fulminant pulmonary embolism mortality is extremely high, with 50% of all deaths occurring within 2 hours after the onset of symptoms. We describe 2 cases of massive pulmonary embolism accompanied by cardiac arrest requiring cardiopulmonary resuscitation. The patients received 100 mg of recombinant tissue-type plasminogen activator in bolus injection and showed a definite improvement in the clinical-hemodynamic status. In our opinion, bolus lysis made a definitive contribution to the success of resuscitation. Several other case reports and small series showed successful treatment of pulmonary embolism during similar circumstances using high-dose bolus injection of thrombolytic agents. We conclude that bolus administration of thrombolytic agents during cardiopulmonary resuscitation for massive pulmonary embolism may be an acceptable and successful technique, available also in community hospitals.

Aged↗
PubMed1995

[Heart arrest in children after intravenous injection of succinylcholine in the ENT operating room].

Acute rhabdomyolysis with hyperkalemia has been followed by ventricular dysrhythmia, cardiac arrest and death after the administration of succinylcholine to apparently healthy children who were subsequently found to have undiagnosed skeletal muscle myopathies. Boys have mostly been affected. Reports of anesthesia emergencies from the United States and Germany have indicated that serious side effects of succinylcholine are not as rare as previously thought. This disorder often presents as sudden cardiac arrest within minutes after the administration of the drug. The tragedy is that an apparently healthy child dies abruptly during what was considered to be a relatively uncomplicated surgical procedure (most often in ENT surgery). Due to the abrupt onset of rhabdomyolysis, routine resuscitative measures are likely to be unsuccessful. Extraordinary measures (including institution of extracorporeal circulation) and prolonged efforts have resulted in successful resuscitation of some cases. Since there are usually no signs or symptoms to alert the practitioner to patients at risk, the use of succinylcholine in children should be reserved for emergency intubations or instances in which immediate securing of the airway is necessary.

Child↗
PubMed1999

[Adenosine-induced heart arrest for endovascular reconstruction of thoracic aneurysms of the aorta].

INTRODUCTION: Endovascular stent-graft repair is a less invasive technique than traditional open aortic reconstruction for strictly selected patients with descending thoracic aortic aneurysms. To prevent distal migration of the device as a result of the propulsive flow during systole, it is helpful to induce temporary asystole for > or = 20 s while the stent-graft is placed in the thoracic aorta. CASE STUDY: We report here a case study of a patient who was given a bolus dose of 60 mg of adenosine to induce temporary asystole. Placement of the stent-graft was successfully performed during the temporary asystole. After 45 s the patient returned to normal sinus rhythm. He was extubated 4 h after the conclusion of surgery and was discharged after 1 week. CONCLUSION: Induction of temporary asystole with bolus adenosine to facilitate placement of stent-grafts in the thoracic aorta is a simple, easy and effective method of avoiding distal device migration.

Adenosine↗
PubMed1993

[Severe anaphylactic shock with heart arrest caused by coffee and gum arabic, potentiated by beta-blocking eyedrops].

The case of a male patient who experienced four allergic accidents after drinking coffee is reported. Two serious anaphylactic reactions with cardiac arrest occurred after a continuous treatment with beta-blocking eye drops (timolol) was prescribed. Dual sensitivation to coffee and to the gum arabic coating roasted coffee beans was demonstrated by skin prick tests and by human basophil degranulation tests. Occupational allergy to green coffee has been widely described, but food sensitization to these two allergens has not yet been reported. This case also draws attention to the risk, inherent in beta-blockers, of immuno-allergic reactions. These drugs produce a loss of compensatory cardiovascular mechanisms and make those who take them resistant to the conventional treatment of anaphylactic shocks, which explains the serious accidents that occurred in this patient. The authors stress the usefulness of a thorough investigation for food allergy to a rare allergen in patients with idiopathic anaphylaxis.

Aged↗
PubMed1993

[Anesthetic-induced heart arrest. A case report of 2 infants with previously unrecognized muscular dystrophy].

We report two boys aged 4 and 10 months who suffered cardiac arrests after induction of anaesthesia. Both infants had no personal or family history of myopathy. In both cases anaesthesia was induced by inhalation with halothane and N2O/O2 (70/30). To facilitate tracheal intubation both were given succinylcholine after the administration of atropine. The 4-month-old developed muscle rigidity and cardiac arrest occurred immediately after tracheal intubation. Resuscitation was unsuccessful. Laboratory findings during resuscitation showed elevated serum potassium levels of more than 10 mmol/l and serum creatine phosphokinase 17.700 IU/l. Histopathologic examination of the skeletal muscle revealed congenital muscular dystrophy. In the older boy no muscle contractures were noted after administration of succinylcholine. He developed bradycardia that progressed to asystole 15 min after induction of anaesthesia. After 1 h of resuscitation a sinus rhythm could be established. The boy developed myoglobinuria and his serum creatine phosphokinase reached a maximum level of 45,000 IU/l on the 2nd day. The child survived and made a complete recovery. Two months later a muscle biopsy taken from the quadriceps showed marked muscular dystrophy. Duchenne's muscular dystrophy could be excluded. The most likely underlying reasons for these complications are discussed: anaesthesia-induced acute rhabdomyolysis or malignant hyperthermia.

Anesthesia↗
PubMed1984

[Heart arrest during dextran infusion despite hapten blockade].

In a running clinical prospective study on the incidence of adverse reactions to colloidal polysaccharides (randomised, single blind, n = 300) a bronchospasm followed by cardiac arrest occurred during dextran infusion although the necessary hapten blockage with monovalent dextran-1 had been effected. Resuscitation was successful. Directly after this, surgery was carried out as planned under general anaesthesia. The 69-year-old patient was discharged without noticeable sequelae. For the first time in the literature on dextran the studied sample allows a generalisation: The event occurred with an incidence of about 0.9% (of 116 patients who had received dextran infusion). This incidence corresponds to a confidence interval ranging from 0.02 to 4.96%. If the study would be continued as planned, the upper limit of this interval signals the probability of another case of severe intolerance. The diagnosis "dextran adverse reaction" can be made in this case by clinical symptoms. Since no previous or concomitant medication had been administered as provided in the protocol to confirm the diagnosis as an adverse reaction to dextran by determination of the titer of dextran antibodies prior to infusion is not required and it may be concluded that dextran was the causative agent.

Aged↗
PubMed2003

[Heart arrest during fibro-bronchoscopic intubation in a patient with parapharyngeal space neoplasia].

A 37-year-old woman a diagnosis of squamous carcinoma of the tongue and a history of partial/hemiglossectomy with cervical lymphadenectomy and postoperative radiotherapy was scheduled for biopsy under general anesthesia given the suspicion of local recurrence. She underwent routine preparation for intubation with a fiberoptic bronchoscope with topical anesthesia of mucosal tissue without sedation. Syncope and asystole presented suddenly during intubation and external cardiopulmonary resuscitation and difficult ventilation through a face mask were necessary. She was finally intubated using a retrograde technique and recovered heartbeat after 20 minutes. No neurological sequelae were observed over the next few days. The etiologic diagnosis of this rare complication was later based on the appearance of the characteristic clinical profile of glossopharyngeal neuralgia-asystole syndrome in combination with parapharyngeal space lesion syncope syndrome; magnetic resonance findings of extensive neoplastic invasion of the space confirmed the diagnosis. Endotracheal intubation with a fiberoptic bronchoscope plays an important role in the management of the anticipated difficult airway. It is safe in the awake patient and facilitates the identification of structures, particularly when there are anatomical alterations due to neoplastic invasion, surgery, or radiotherapy. In the patient we describe, however, stimulation caused asystole.

Adult↗
PubMedDate not supplied

[3-year-survival and quality of life after out-of-hospital heart arrest].

Although the long- and short-term aspects of the outcome of advanced cardiopulmonary resuscitation on patients have been studied to evaluate the percentage of survival up to the moment of discharge from hospital, little information has been published concerning the patients' long-term quality of life. In order to verify the efficiency of our group we retrospectively evaluated 468 subjects admitted to the Emergency Room of Rho Hospital (Milan, Italy) for out-of-hospital cardiac arrest that had occurred over a 90-month period. We studied the correlations between some variables: epidemiological (sex and age), objective (time required for advanced cardiopulmonary resuscitation and type of arrhythmias in the Emergency Room) and instrumental (left ventricular ejection fraction) and post-discharge survival. We also considered the state of health of the survivors by means of a questionnaire on their quality of life. Our data show that: a) 10.25% of the patients were discharged alive; b) younger men (< 65 years old) admitted with a ventricular fibrillation (p = 0.01) and those who had undergone advanced cardiopulmonary resuscitation for less than 25 min (p = 0.001) had a better survival rate at 3 years from discharge; c) 64% of the survivors have a satisfactory quality of life; d) younger age (p = 0.01) and cardiac left ventricular ejection fraction (> 40%) (p = 0.05) are positive predictors for future work capacity. In conclusion, we believe that the critical moment following advanced cardiopulmonary resuscitation is hospitalization because after discharge survival percentage abruptly increased from 10.25 to 65%.

Activities of Daily Living↗