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Korean J Med > Volume 88(4); 2015 > Article
The Korean Journal of Medicine 2015;88(4): 434-437.
심정지 이후에 장시간 시행된 흉부압박에 의해 발생한 우심실 파열 1예
이희정1, 권성순1, 강혜란1, 방덕원1, 박병원1, 이민호1, 장원호2
1순천향대학교 의과대학 순천향대학교 서울병원 내과
2순천향대학교 의과대학 순천향대학교 서울병원 흉부외과
Right Ventricular Rupture Caused by Prolonged Cardiopulmonary Resuscitation after Sudden Cardiac Arrest
Hee Jeong Lee1, Seong Soon Kwon1, Hye Ran Kang1, Duk Won Bang1, Byoung Won Park1, Min-Ho Lee1, Won-Ho Chang2
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.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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
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