Fatal pulmonary embolism and coincidental cerebral infarction after spinal anesthesia -A case report-

Abstract

A pulmonary embolism and cerebral infarction are the second and third most common acute cardiovascular diseases after a myocardial infarction. Early diagnosis and appropriate management are important clinical challenges. In this case, a fatal pulmonary embolism and extensive cerebral infarction caused cardiac arrest during spinal anesthesia for total hip replacement surgery. Transesophageal echocardiography indicated a pulmonary embolism and brain CT showed large area of acute infarction at right middle cerebral artery territory. Pulmonary CT angiogram revealed massive pulmonary embolism findings. This paper reviews this case and suggests other preventive modalities.

Fatal cardiac thromboembolism in a patient with a pacemaker during ureteroscopic lithotripsy for ureter stone: a case report

“…Primary risk factors for pulmonary embolism (PE) include: deficiencies of antithrombin III, proteins C or S. Secondary risk factors comprise the history of deep vein thrombosis (DVT) or PE, immobilization, pregnancy, lower limb fracture, heart failure, obesity, cancer, a surgical operation lasting longer than 30 minutes, patients older than 40 years of age, and intraoperative leg elevation [ 8 ]. This patient had several risk factors including; 1) surgical operation lasting longer than 30 min; 2) older than 40 years of age and; 3) intraoperative leg elevation, for DVT and PE.…”