Successful Recovery After Prolonged Cardiopulmonary Resuscitation and Rescue Thrombolytics in a Patient with Cardiac Arrest Secondary to Presumed Massive Pulmonary Embolism

Abstract

Wei Liu,1 Li-Na Liu,1 Cai-Wei Lin,1 Hao-Yu Wang,2 Xu-Dong Wang1 1Department of Emergency, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), Beijing, 100049, People’s Republic of China; 2Department of Radiology, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), Beijing, 100049, People’s Republic of ChinaCorrespondence: Xu-Dong WangDepartment of Emergency, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), No. 15 of Yuquan Street, Haidian District, Beijing, 100049, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: We present the case of a 60-year-old woman who suddenly suffered a witnessed cardiac arrest and did not achieve return of spontaneous circulation despite being given 150-minute ultra-long cardiopulmonary resuscitation (CPR). During CPR, pulmonary embolism was suspected and was eventually diagnosed based on refractory pulseless electrical activity, elevated serum D-dimmer, and a markedly enlarged right ventricle chamber. After rescue thrombolytic alteplase therapy, the patient was successfully resuscitated and had a good neurological recovery.Keywords: cardiac arrest, pulmonary embolism, thrombolysis

Keywords

• cardiac arrest
• pulmonary embolism
• thrombolysis