Aortic luminal thrombus and intramural hematoma after cardiopulmonary resuscitation

Abstract

We describe the case of a patient with an intramural hematoma and floating thrombus after cardiopulmonary resuscitation. The 92-year old man had a cardiac arrest due to ventricular fibrillation and witnesses immediately initiated manual cardiopulmonary resuscitation. Transesophageal echocardiography was performed immediately on hospital admission because the patient was in cardiogenic shock. In addition to an akinetic anterior wall, examination of the descending thoracic aorta demonstrated an intramural hematoma and a floating intra-aortic thrombus at a distance of 40cm from the dental arch. There was no aortic dissection. The thrombus was attributed to aortic compression during cardiopulmonary resuscitation. Although the aortic thrombus and intramural hematoma were not associated with any complications in this patient, insertion of an intra-aortic balloon may have led to aortic rupture or embolic events. Transesophageal echocardiography should be performed, when available, prior to insertion of an intra-aortic balloon for counterpulsation in patients who have undergone cardiopulmonary resuscitation.

Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case

“…Acute intramural aortic hematomas, which can lead to fatal aortic rupture, 10 have been described as an uncommon complication of CPR. 11 In our case, progression of the size of hematoma demonstrated that lesion happened due to CPR and was not old. Limited reports of these lesions are available, and mostly, aortic lesions after CPR are diagnosed in autopsy.…”

Aortic Dissection in a Survivor after Cardiopulmonary Resuscitation

“…Aortic dissection after CPR has rarely been reported in survivors [11-13]. Most blunt aortic injuries occur in the proximal descending aorta, where the relatively mobile aortic arch joins the fixed descending aorta via the ligamentum arteriosum.…”

Aortic floating thrombus detected by computed tomography angiography incidentally: Five cases and a literature review

“…4,[7][8][9][10][11][12] There are also some cases with rare concomitant disorders that may be the underlying factors of ALFT (Table 3). [13][14][15][16][17][18][19] Some findings on CT may provide clues to explore the cause of lesion. In our study, 4 of 5 ALFTs were attached to the focal thickened walls of aorta with or without calcifications, which suggested the presence of atherosclerotic plaques.…”