ECPR for cardiac arrest caused by abnormal uterine bleeding and coronary vasospasm: a case report.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Frontiers in Cardiovascular Medicine Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1481498
Qiping Sheng, Yingjie Wang, Zhiyang Wu, Xiangyang Zhao, Dawei Wu, Zhi Li, Xi Guo
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Abstract

Introduction: Cardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). We report a case in which extracorporeal cardiopulmonary resuscitation (ECPR) was used in a patient with cardiac arrest caused by AUB and coronary vasospasm.

Patient presentation: A 52-year-old female patient presented to the emergency department because of sudden chest pain, with a history of hypertension, coronary heart disease and AUB for more than half a month. At the initial stage of admission, cardiac arrest occurred after the ECG demonstrated ST-segment elevation in leads II, III and a VF. ECPR was started after traditional cardiopulmonary resuscitation, and coronary angiography was performed with the support of extracorporeal membrane oxygenation (ECMO). The left and right coronary arteries were slender and narrow, which was relieved after the injection of 100 µg nitroglycerine through the left coronary artery. After performing a coronary angiogram, the patient was given long-acting nitrates and calcium channel blockers orally, and her chest pain did not reoccur. The patient was weaned from ECMO support after 4 days.

Conclusion: This clinical case highlights the challenges that clinicians face in accurately diagnosing and possibly treating AUB and coronary vasospasm-induced acute myocardial infarction because of its rare occurrence and serious adverse events. ECPR can effectively improve the success rate of cardiopulmonary resuscitation.

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ECPR治疗子宫异常出血合并冠状动脉痉挛致心脏骤停1例。
妊娠期心脏骤停越来越受到人们的关注。然而,关于子宫异常出血(AUB)引起的非妊娠妇女心脏骤停的报道很少。我们报告一例体外心肺复苏(ECPR)被用于病人心脏骤停引起的AUB和冠状动脉血管痉挛。患者介绍:52岁女性,因突发性胸痛就诊于急诊科,既往有高血压、冠心病、AUB病史半个多月。入院初期,心电显示II、III导联st段抬高和VF后发生心脏骤停。传统心肺复苏后启动ECPR,在体外膜氧合(ECMO)支持下行冠状动脉造影。左、右冠状动脉细长狭窄,经左冠状动脉注射100µg硝酸甘油后缓解。在进行冠状动脉造影后,患者口服长效硝酸盐和钙通道阻滞剂,她的胸痛没有再发生。4天后,患者脱离ECMO支持。结论:该临床病例因其罕见且不良事件严重,凸显了临床医生在准确诊断和可能治疗AUB和冠状动脉痉挛性急性心肌梗死方面所面临的挑战。ECPR能有效提高心肺复苏成功率。
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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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