Klintschar M, Darok M, Radner H
Institute of Legal Medicine, University of Graz, Austria.
Int J Legal Med. 1998;111(2):93-6. doi: 10.1007/s004140050123.
An 84-year-old woman was unsuccessfully resuscitated for 3 min using standard cardiopulmonary resuscitation (CPR), followed by 15 min of active compression-decompression (ACD). The autopsy revealed that death was due to myocardial infarction complicated by rupture of the infarcted area and pericardial tamponade was diagnosed. Furthermore, a series of rib fractures, a transverse fracture of the sternum, rupture of the pericardial sac, the right ventricle, both atria and lacerations of the ascending aorta, were found with no signs of a vital reaction. To our knowledge, such extensive cardiac injury after CPR has not been previously reported. It is suggested that the pre-existing pericardial tamponade, the age of the patient and the application of the ACD-device to incorrect areas of the chest contributed to the extent of the cardiac injury. This case further adds to the suspicion of an increased risk of cardiac injuries when using an ACD device for cardiac massage.
一名84岁女性接受标准心肺复苏（CPR）3分钟复苏失败，随后进行了15分钟的主动按压-减压（ACD）。尸检显示死亡原因是心肌梗死并发梗死区域破裂，诊断为心包填塞。此外，还发现一系列肋骨骨折、胸骨横断骨折、心包囊破裂、右心室、双心房破裂以及升主动脉撕裂，均无生命反应迹象。据我们所知，此前尚未报道过CPR后出现如此广泛的心脏损伤。提示既往存在的心包填塞、患者年龄以及ACD装置应用于胸部不正确区域导致了心脏损伤的程度。该病例进一步增加了使用ACD装置进行心脏按摩时心脏损伤风险增加的怀疑。
