Publication: A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?
Abstract
Giriş: Tüm inmelerin %20'si hemorajik ve hemorajik inmelerin %50'si subaraknoid kanamadır. Kardiyak anormallikler ve elektrokardiyografik değişikler subaraknoid kanama sonrası sık görülür. Biz bu vakada ani gelişen bilinç kaybı sonrası önce solunum arresti, sonra kardiyak arrest olan ve elektrokardiyografisinde difüz ST segment değişiklikleri görülen bir hastayı sunacağız.Olgu Sunumu: 52 yaşında, özgeçmişinde sadece hipertansiyonu olan bayan hasta eşinin künt kafa travması sonrası dekompresif kraniektomi yapıldığını öğrenmiş. Eşi operasyon sonrası yoğun bakıma gönderilirken acil servisin hemen dışında yere yığılmış. Acil servise alınan hastada solunum arresti geliştiği görüldü. Ardından ventriküler fibrilasyona giren hastada kardiyopulmoner resüsitasyona başlandı ve 200 joule ile defibrile edildi. Başarılı resüsitasyon sonrası nabız alındı ve elektrokardiografide atrial fibrilasyon ritmi ve yaygın ST segment elevasyonları görüldü. Perkütan koroner girişim planlanan hastaya acil doktorlarının şüphesi üzerine kranial bilgisayarlı tomografi çekildi. Sonuç şaşırtıcı değildi, hastada yaygın subaraknoid kanama saptandı.Sonuç: Klinik bulgular ve hastanın öyküsü, malpraktisin önlenmesinde çok önemlidir. Hekimler bunlara yeterli dikkati göstermezse, hastalar kolaylıkla yanlış tedavi edilebilir
Introduction: Twenty percent of all strokes are hemorrhagic and 50% of hemorrhagic strokes are because of subarachnoid hemorrhage (SAH). Cardiac abnormalities and electrocardiographic (ECG) changes are commonly seen after SAH. Here, we present a patient with a sudden loss of consciousness, respiratory arrest, and diffuse ST segment changes in ECG.Case Report: A 52-year-old wife, who had only hypertension in her medical history, learnt that her husband had a blunt trauma to the head and a decompressive craniectomy was performed. While he was sent to an intensive care unit, his wife collapsed just outside the emergency department (ED). The female patient had a respiratory arrest and then entered ventricular fibrillation. After Cardiopulmonary resuscitation (CPR) and 200 J defibrillation, the monitor showed an atrial fibrillation rhythm and the pulse returned. The ECG showed elevations in ST segments and a percutaneous coronary intervention was planned. Meanwhile, emergency physicians suspected an intracranial pathology and a computed tomography (CT) scan revealed a diffuse SAH.Conclusion: The clinical findings and the patient history are very important to avoid malpractice. If the physicians do not give sufficient attention to these areas, the patients can easily be mistreated
Introduction: Twenty percent of all strokes are hemorrhagic and 50% of hemorrhagic strokes are because of subarachnoid hemorrhage (SAH). Cardiac abnormalities and electrocardiographic (ECG) changes are commonly seen after SAH. Here, we present a patient with a sudden loss of consciousness, respiratory arrest, and diffuse ST segment changes in ECG.Case Report: A 52-year-old wife, who had only hypertension in her medical history, learnt that her husband had a blunt trauma to the head and a decompressive craniectomy was performed. While he was sent to an intensive care unit, his wife collapsed just outside the emergency department (ED). The female patient had a respiratory arrest and then entered ventricular fibrillation. After Cardiopulmonary resuscitation (CPR) and 200 J defibrillation, the monitor showed an atrial fibrillation rhythm and the pulse returned. The ECG showed elevations in ST segments and a percutaneous coronary intervention was planned. Meanwhile, emergency physicians suspected an intracranial pathology and a computed tomography (CT) scan revealed a diffuse SAH.Conclusion: The clinical findings and the patient history are very important to avoid malpractice. If the physicians do not give sufficient attention to these areas, the patients can easily be mistreated