Trochanteric hip fracture during cardioversion therapy. A case report

Abstract

HighlightsThe propofol sedation should be complemented with skeletal muscle relaxants in the cardioversion therapy to avoid hip fracture in select patients with osteoporosis.Hip fracture in osteoporotic bones should be considered after muscle violent contraction that causes hip pain and functional impotence.

Management of a complex acetabular fracture following defibrillation for ventricular fibrillation cardiac arrest

“…This case highlights a small, but relevant, risk of fracture following defibrillation or cardioversion in patients with either osteoporosis or previous fracture, which should be investigated if patients reported pelvic/hip pain following a shock. In cases of ventricular fibrillation cardiac arrest, patients should receive immediate treatment including defibrillation as per Advanced Life Support guidelines4; however, the use of muscle relaxants may be considered in the context of elective cardioversion 3…”

“…A previous case report described an acetabular fracture in the context of both a tonic–clonic seizure and defibrillation following MI, but whether the fracture was secondary to either the seizure or cardioversion remained unknown. 1 Other case reports have highlighted both subtrochanteric 2 and trochanteric 3 femoral fractures following electrical cardioversion. In all of these cases, patients had either osteoporosis or previous femoral fracture.…”

“…In cases of ventricular fibrillation cardiac arrest, patients should receive immediate treatment including defibrillation as per Advanced Life Support guidelines 4 ; however, the use of muscle relaxants may be considered in the context of elective cardioversion. 3 …”

“…In cases of ventricular fibrillation cardiac arrest, patients should receive immediate treatment including defibrillation as per Advanced Life Support guidelines 4 ; however, the use of muscle relaxants may be considered in the context of elective cardioversion. 3 Around 100 000 PCIs are performed in the UK each year. 5 The European Society of Cardiology (ESC) recommends (IA recommendation) 12 months of DAPT, with a P2Y 12 inhibitor on top of aspirin, for 12 months following acute MI with coronary stent implantation, to reduce the risk of both stent thrombosis and restenosis.…”