In-hospital cardiac arrest due to pulmonary embolism – Treatment and outcomes in a Swedish cohort study

Henriksson, Caspar Epstein; Frithiofsson, Johanna; Bruchfeld, Samuel; Bendz, Emma; Bruzelius, Maria; Djärv, Therese

doi:10.1016/j.resplu.2021.100178

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…Pregnancy entails a 10-fold increased risk of venous thromboembolism (13/10,000, of which approximately 20% are due to PE) and an increased risk of complications such as aortic dissection, stroke and cardiomyopathy [1] . A recent review in Stockholm in 2021 showed that 3% of all IHCA were caused by PE [2] . In comparison with non-thrombolysed patients, the survival rate for IHCA with thrombolysis was 44% (7/16) vs. 8% (4/48) [2] .…”

Section: Discussionmentioning

confidence: 99%

“…A recent review in Stockholm in 2021 showed that 3% of all IHCA were caused by PE [2] . In comparison with non-thrombolysed patients, the survival rate for IHCA with thrombolysis was 44% (7/16) vs. 8% (4/48) [2] . Approximately 3% of all cases with OHCA were caused by PE and of the 17% who did not die at the scene, the respective 30-day survival rate was 16% if thrombolysis was given and 6% if not [6] .…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary embolism (PE) is rare condition in the general population (2/10,000), but causes one in six cases of maternal mortality [1] . Non-pregnant patients with inhospital cardiac arrest (IHCA) due to PE have an 8% chance of survival without thrombolysis [2] . The prognosis of out-ofhospital cardiac arrest (OHCA) is even worse, although there are some case reports of pregnant women surviving [3] .…”

Section: Introductionmentioning

confidence: 99%

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Cardiac arrest due to out-of-hospital pulmonary embolism during pregnancy: successful thrombolysis

Söderberg

Smedberg

Lindqvist

2023

European Journal of Case Reports in Internal Medicine

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Introduction: Pulmonary embolism (PE) is a rare, severe complication in pregnancy, in which case thrombolysis can be lifesaving but has risks. We aim to highlight actions specific to pregnant women. Case Description: A 24-week pregnant woman developed shortness of breath and experienced sudden cardiac arrest. Cardiopulmonary resuscitation (CPR) was begun immediately in the ambulance and a perimortem caesarean section was performed upon arrival at hospital, but the new-born died. After 55 minutes of CPR, bedside echocardiography revealed right ventricular strain and thrombolysis was given. The uterus was bandaged to minimize blood loss. After massive transfusions and correction of haemostasis, a hysterectomy was performed due to inability of the uterus to contract. After 3 weeks, the patient was discharged in good health and placed on continuous anticoagulant treatment with warfarin. Discussion: Approximately 3% of all out-of-hospital cardiac arrest cases are due to PE. Among the few patients who survive at the scene, thrombolysis can be lifesaving and should be considered in pregnant women with unstable PE. Prompt collaborative diagnostic work-up in the emergency room is necessary. In a pregnant woman with cardiac arrest, a perimortem caesarean section improves the chances of both maternal and fetal survival. Conclusion: Thrombolysis should be considered for patients with PE in pregnancy with the same indications as in a non-pregnant woman. In case of survival, there is profuse bleeding with need for massive transfusions and haemostasis correction. Despite being in very poor condition, the above patient survived and was fully restored to health.

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Section: Discussionmentioning

confidence: 99%