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St Elevasyonlu Kardiyopulmoner Arrest Olgusu: Temel Sebep Ne İdi?

Year 2015, Volume: 6 Issue: 2, 39 - 42, 01.04.2015

Emre Salçın Can Özen Serhad Ömercikoğlu Merter Gümüşel Serkan Emre Eroğlu , Haldun Akoğlu Özge Onur

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.

Keywords

Subaraknoid kanama EKG değişiklikleri anevrizma

References

  • Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive summary: heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation 2010; 121: 948-54. [CrossRef]
  • Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, et al. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006; 355: 2308-20. [CrossRef]
  • Gu YL, Svilaas T, van der Horst IC, Zijlstra F. Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention. Neth Heart J 2008; 16: 325-31. [CrossRef]
  • van der Bilt IA, Hasan D, Vandertop WP, Wilde AA, Algra A, Visser FC, et al. Impact of cardiac complications on outcome after aneurysmal subarachnoid hemorrhage: a meta-analysis. Neurology 2009; 72: 635- 42. [CrossRef]
  • Singer RJ, Ogilvy CS, Rordorf G. Etiology, clinical manifestations, and diagnosis of aneurysmal subarachnoid hemorrhage. UpToDate®, 2013, www.uptodate.com/contents/etiology-clinical-manifestations-and- diagnosis-of-aneurysmal-subarachnoid-hemorrhage. Last accessed 28/03/2015
  • Yüce M, Davutoğlu V, Alptekin M, Yavuz F, Alıcı MH, Yıldırım C. Akut koroner sendromu taklit eden subaraknoid kanama vakası. AKATOS 2010; 1: 31-3.
  • Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A. Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case- crossover study. Stroke 2011; 42: 1878-82. [CrossRef]
  • Gorelick PB, Hier DB, Caplan LR, Langenberg P. Headache in acute cerebrovascular disease. Neurology 1986; 36: 1445-50. [CrossRef]
  • Schneider HJ, Kreitschmann-Andermahn I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systema-tic review. JAMA 2007; 298: 1429-38. [CrossRef]
  • Naidech AM, Kreiter KT, Janjua N, Ostapkovich ND, Parra A, Commichau C, et al. Cardiac tropo-nin elevation, cardiovascular morbidity, and outcome after subarachnoid hemorrhage. Circulation 2005; 112: 2851- 6. [CrossRef]

A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?

Year 2015, Volume: 6 Issue: 2, 39 - 42, 01.04.2015

Emre Salçın Can Özen Serhad Ömercikoğlu Merter Gümüşel Serkan Emre Eroğlu , Haldun Akoğlu Özge Onur

Abstract

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

Keywords

Subarachnoid hemorrhage ECG changes aneurysm

References

  • Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive summary: heart disease and stroke statistics-2010 update: a report from the American Heart Association. Circulation 2010; 121: 948-54. [CrossRef]
  • Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, et al. Strategies for reducing the door-to-balloon time in acute myocardial infarction. N Engl J Med 2006; 355: 2308-20. [CrossRef]
  • Gu YL, Svilaas T, van der Horst IC, Zijlstra F. Conditions mimicking acute ST-segment elevation myocardial infarction in patients referred for primary percutaneous coronary intervention. Neth Heart J 2008; 16: 325-31. [CrossRef]
  • van der Bilt IA, Hasan D, Vandertop WP, Wilde AA, Algra A, Visser FC, et al. Impact of cardiac complications on outcome after aneurysmal subarachnoid hemorrhage: a meta-analysis. Neurology 2009; 72: 635- 42. [CrossRef]
  • Singer RJ, Ogilvy CS, Rordorf G. Etiology, clinical manifestations, and diagnosis of aneurysmal subarachnoid hemorrhage. UpToDate®, 2013, www.uptodate.com/contents/etiology-clinical-manifestations-and- diagnosis-of-aneurysmal-subarachnoid-hemorrhage. Last accessed 28/03/2015
  • Yüce M, Davutoğlu V, Alptekin M, Yavuz F, Alıcı MH, Yıldırım C. Akut koroner sendromu taklit eden subaraknoid kanama vakası. AKATOS 2010; 1: 31-3.
  • Vlak MH, Rinkel GJ, Greebe P, van der Bom JG, Algra A. Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case- crossover study. Stroke 2011; 42: 1878-82. [CrossRef]
  • Gorelick PB, Hier DB, Caplan LR, Langenberg P. Headache in acute cerebrovascular disease. Neurology 1986; 36: 1445-50. [CrossRef]
  • Schneider HJ, Kreitschmann-Andermahn I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systema-tic review. JAMA 2007; 298: 1429-38. [CrossRef]
  • Naidech AM, Kreiter KT, Janjua N, Ostapkovich ND, Parra A, Commichau C, et al. Cardiac tropo-nin elevation, cardiovascular morbidity, and outcome after subarachnoid hemorrhage. Circulation 2005; 112: 2851- 6. [CrossRef]
There are 10 citations in total.

Details

Other ID JA89HN73NE
Journal Section Case Report
Authors

Emre Salçın This is me

Can Özen This is me

Serhad Ömercikoğlu This is me

Merter Gümüşel This is me

Serkan Emre Eroğlu

Haldun Akoğlu This is me

Özge Onur This is me

Publication Date April 1, 2015
Submission Date April 1, 2015
Published in Issue Year 2015 Volume: 6 Issue: 2

Cite

APA Salçın, E., Özen, C., Ömercikoğlu, S., Gümüşel, M., et al. (2015). A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?. Journal of Emergency Medicine Case Reports, 6(2), 39-42.
AMA Salçın E, Özen C, Ömercikoğlu S, Gümüşel M, Eroğlu SE, Akoğlu H, Onur Ö. A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?. Journal of Emergency Medicine Case Reports. April 2015;6(2):39-42.
Chicago Salçın, Emre, Can Özen, Serhad Ömercikoğlu, Merter Gümüşel, Serkan Emre Eroğlu, Haldun Akoğlu, and Özge Onur. “A Case of Cardiopulmonary Arrest With ST Elevation: What Was the Main Cause?”. Journal of Emergency Medicine Case Reports 6, no. 2 (April 2015): 39-42.
EndNote Salçın E, Özen C, Ömercikoğlu S, Gümüşel M, Eroğlu SE, Akoğlu H, Onur Ö (April 1, 2015) A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?. Journal of Emergency Medicine Case Reports 6 2 39–42.
IEEE E. Salçın, C. Özen, S. Ömercikoğlu, M. Gümüşel, S. E. Eroğlu, H. Akoğlu, and Ö. Onur, “A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?”, Journal of Emergency Medicine Case Reports, vol. 6, no. 2, pp. 39–42, 2015.
ISNAD Salçın, Emre et al. “A Case of Cardiopulmonary Arrest With ST Elevation: What Was the Main Cause?”. Journal of Emergency Medicine Case Reports 6/2 (April 2015), 39-42.
JAMA Salçın E, Özen C, Ömercikoğlu S, Gümüşel M, Eroğlu SE, Akoğlu H, Onur Ö. A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?. Journal of Emergency Medicine Case Reports. 2015;6:39–42.
MLA Salçın, Emre et al. “A Case of Cardiopulmonary Arrest With ST Elevation: What Was the Main Cause?”. Journal of Emergency Medicine Case Reports, vol. 6, no. 2, 2015, pp. 39-42.
Vancouver Salçın E, Özen C, Ömercikoğlu S, Gümüşel M, Eroğlu SE, Akoğlu H, Onur Ö. A Case of Cardiopulmonary Arrest with ST Elevation: What was the Main Cause?. Journal of Emergency Medicine Case Reports. 2015;6(2):39-42.