Fosse E, Lindberg H
Department of Surgery, A, Rikshospitalet, Oslo, Norway.
Acta Anaesthesiol Scand. 1996 Apr;40(4):502-4. doi: 10.1111/j.1399-6576.1996.tb04476.x.
A case of a 62-year-old woman suffering an acute cardiac arrest during a court dispute is presented. Cardiopulmonary resuscitation was immediately started by bystanders. In hospital there were signs of intrathoracic bleeding. A left thoracotomy revealed a cardiac rupture of the left ventricle and a large pericardial tear. Intraoperative evaluation of the heart as well as postoperative enzyme levels and ECG did not indicate acute myocardial infarction. The rupture may therefore be traumatic. The cardiac rupture was sutured five hours after the initial resuscitation, and the patient discharged from the intensive care unit two days after the rupture without clinical signs of neurological injury. A precordial thump is advised before start of external chest compression. One beneficial effect may be that the ventricles empty and the risk of traumatic rupture during compression is reduced.
本文介绍了一例62岁女性在法庭纠纷期间发生急性心脏骤停的病例。旁观者立即开始进行心肺复苏。在医院检查发现有胸腔内出血迹象。左侧开胸手术显示左心室心脏破裂和心包大面积撕裂。术中对心脏的评估以及术后酶水平和心电图检查均未提示急性心肌梗死。因此，这种破裂可能是外伤性的。在初次复苏后5小时对心脏破裂进行了缝合，破裂后两天患者从重症监护病房出院，没有神经损伤的临床迹象。建议在开始胸外按压前进行心前区叩击。一个有益的效果可能是心室排空，从而降低按压期间外伤性破裂的风险。
