Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.526
Filtrar
1.
BMJ Case Rep ; 14(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285016

RESUMO

Ictal bradycardia and asystole are rare, but potentially serious complications of epileptic seizures. We present a case series of three such patients diagnosed through our syncope service. For two patients, treatment with anticonvulsant therapy alone achieved symptom control. The third patient was initially managed with permanent pacemaker insertion due to detection of a significant ventricular pause. He subsequently developed more pronounced symptoms suggestive of seizure.Ictal asystole can cause significant diagnostic challenge and management strategies remain controversial due to the overlap in presentation to cardiology and neurology services. The number of patients affected is low, impeding the formulation of an evidence base for treatment. We propose multidisciplinary working facilitated by a specialist syncope service as a means of recognising and treating this condition more effectively.


Assuntos
Epilepsia , Parada Cardíaca , Eletrocardiografia , Eletroencefalografia , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Humanos , Masculino , Convulsões/tratamento farmacológico , Convulsões/etiologia , Síncope/etiologia
4.
J Med Case Rep ; 15(1): 376, 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34321075

RESUMO

BACKGROUND: Sudden cardiac arrest during spinal anesthesia is a rare event. However, its management by an unprepared team is difficult and carries poor outcomes. Hypoglycemia as the cause of sudden cardiac arrest is rarely reported. This case illustrates lifesaving procedures for sudden cardiac arrest secondary to hypoglycemia during cesarean delivery under spinal anesthesia. We report a case, from rural Ethiopia of sudden cardiac arrest secondary to hypoglycemia during cesarean delivery under spinal anesthesia. The case was successfully managed by a team of anesthetists and other operating teams. The mother and newborn were discharged from the hospital on the 7th postoperative day. CONCLUSION: Hypoglycemia during cesarean delivery under spinal anesthesia can cause sudden cardiac arrest. Therefore, identifying patients at risk of developing hypoglycemia, monitoring the patient's condition, and initiating prompt intervention at the first sign of cardiovascular instability is advisable. Determining serum blood glucose levels at admission to the labor ward and monitoring blood glucose levels during spinal anesthesia should be routine practices.


Assuntos
Raquianestesia , Parada Cardíaca , Hipoglicemia , Raquianestesia/efeitos adversos , Morte Súbita Cardíaca , Etiópia , Feminino , Parada Cardíaca/etiologia , Humanos , Hipoglicemia/etiologia , Recém-Nascido , Gravidez
5.
Am J Case Rep ; 22: e931215, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34228699

RESUMO

BACKGROUND Approximately 290 000 cases of in-hospital cardiac arrest occur annually, the majority of which are due to cardiac or respiratory causes. Cardiac arrest due to acute pulmonary embolism (PE) is associated with a 90% incidence of mortality and, if identified, it can be treated with systemic thrombolytics. Here, we describe a case in which the outcome for such an event was favorable. CASE REPORT A 66-year-old woman was admitted with multiple rib and left ankle fractures due to accidental trauma. Before undergoing orthopedic surgery, she experienced a cardiac arrest with pulseless electrical activity, which was witnessed. She had refractory hypoxia and hypotension following intubation and a brief initial return of spontaneous circulation (ROSC) before a second cardiac arrest. A 100-mg bolus dose of systemic thrombolytic therapy was promptly administered, with rapid achievement of sustained ROSC. The results of a subsequent electrocardiogram, echocardiogram, and computed tomography scan further supported the diagnosis of acute PE with right heart strain. Supportive care in the Intensive Care Unit resulted in full neurological recovery and she was discharged to a physical rehabilitation facility 12 days after her cardiac arrest. CONCLUSIONS Systemic thrombolytic therapy is beneficial for cardiac arrest due to acute PE.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca , Embolia Pulmonar , Idoso , Ecocardiografia , Feminino , Fibrinolíticos/uso terapêutico , Parada Cardíaca/etiologia , Humanos , Embolia Pulmonar/complicações , Embolia Pulmonar/tratamento farmacológico , Terapia Trombolítica
6.
J Clin Anesth ; 73: 110366, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34087660

RESUMO

STUDY OBJECTIVE: To determine 30-day-mortality, incidence and characteristics of perioperative cardiac arrest as well as the respective independent risk factors in preterm infants undergoing non-cardiac surgery. DESIGN: Retrospective observational Follow-up-study. SETTING: Bielefeld University Hospital, a German tertiary care hospital. PATIENTS: Population of 229 preterm infants (age < 37th gestational week at the time of surgery) who underwent non-cardiac surgery between 01/2008-12/2018. MEASUREMENTS: Primary endpoint was overall 30-day-mortality. Secondary endpoints were the incidence of perioperative cardiac arrest and identification of independent risk factors. We performed univariate and multivariate analyses and calculated odds ratios (OR) for risk factors associated with these endpoints. MAIN RESULTS: 30-day-mortality was 10.9% and perioperative mortality 0.9%. Univariate risk factors for 30-day-mortality were perioperative cardiac arrest (OR,12.5;95%CI,3.1 to 50.3), comorbidities of lungs (OR,3.7;95%CI,1.2 to 11.3) and gastrointestinal tract (OR,3.5;95%CI,1.3 to 9.6); sepsis (OR,3.6;95%CI,1.4 to 9.5); surgery between 22:01-7:00 (OR,7.3;95%CI,2.4 to 21.7); emergency (OR,4.5;95%CI,1.6 to 12.4); pre-existing catecholamine therapy (OR,5.0;95%CI,2.1 to 11.9). Multivariate logistic regression indicated that perioperative cardiac arrest (OR,13.9;95%CI,2.7 to 71.3), low body weight (weight < 1000 g: OR,26.0;95%CI,3.2 to 212; 1000-1499 g: OR,10.3; 95%CI,1.1 to 94.9 compared to weight > 2000 g), and time of surgery (OR,5.9;95%CI,1.6 to 21.3) for 22:01-7:00 compared to 7:01-15:00) were the major independent risk factors of mortality. Incidence of perioperative cardiac arrests was 3.9% (9 of 229;95%CI,1.8 to 7.3). Univariate risk factors were congenital anomalies of the airways (OR,4.7;95%CI,1.2 to 20.3), lungs (OR,4.7;95%CI,1.2 to 20.3) and heart (OR,8.0;95%CI,2 to 32.2), pre-existing catecholamine therapy (OR,59.5;95%CI,3.4 to 1039), specifically, continuous infusions of epinephrine (OR,432;95%CI,43.2 to 4318). CONCLUSIONS: 30-day-mortality and the incidence of perioperative cardiac arrest of preterms undergoing non-cardiac surgery were higher than previously reported. The identified independent risk factors may improve interdisciplinary perioperative risk assessment, optimal preoperative stabilization and scheduling of optimal surgical timing.


Assuntos
Parada Cardíaca , Recém-Nascido Prematuro , Parada Cardíaca/epidemiologia , Parada Cardíaca/etiologia , Humanos , Incidência , Lactente , Recém-Nascido , Estudos Retrospectivos , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-34067038

RESUMO

The clinical characteristics and laboratory values of patients with septic shock who experience in-hospital cardiac arrest (IHCA) have not been well studied. This study aimed to evaluate the prevalence of IHCA after admission into the emergency department and to identify the factors that increase the risk of IHCA in septic shock patients. This observational cohort study used a prospective registry of septic shock patients and was conducted at the emergency department of a university-affiliated hospital. The data of 887 adult (age ≥ 18 years) septic shock (defined using the Sepsis-3 criteria) patients who were treated with a protocol-driven resuscitation bundle therapy and were admitted to the intensive care unit between January 2010 and September 2018 were analyzed. The primary endpoint was the occurrence of sepsis-associated cardiac arrest. The patient mean age was 65 years, and 61.8% were men. Sepsis-associated cardiac arrest occurred in 25.3% of patients (n = 224). The 28-day survival rate after cardiac arrest was 6.7%. Multivariate logistic regression identified chronic pulmonary disease (odds ratio (OR) 2.06), hypertension (OR 0.48), unknown infection source (OR 1.82), a hepatobiliary infection source (OR 0.25), C-reactive protein (OR 1.03), and serum lactate level 6 h from shock (OR 1.34). Considering the high mortality rate of sepsis-associated cardiac arrest after cardiopulmonary resuscitation, appropriate monitoring is required in septic shock patients with major risk factors for IHCA.


Assuntos
Parada Cardíaca , Sepse , Choque Séptico , Adolescente , Adulto , Idoso , Feminino , Parada Cardíaca/epidemiologia , Parada Cardíaca/etiologia , Humanos , Masculino , Ressuscitação , Estudos Retrospectivos , Fatores de Risco , Sepse/epidemiologia , Choque Séptico/epidemiologia
8.
A A Pract ; 15(5): e01469, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-33999865

RESUMO

Thoracotomies are classified as moderate to high-risk surgeries due to the preponderance of complex anatomic structures, cardiac dysrhythmias, and respiratory insufficiency. The right vagus nerve innervates the sinoatrial node and controls the heart rate. The parasympathetic activation of the sinoatrial node can lead to bradyarrhythmias. The anatomic aortopulmonary window contains lymph nodes and the left vagus nerve. The occurrence of sudden asystole due to left vagus nerve stimulation is extremely rare. We report an unusual case of intraoperative asystole related to electrosurgical stimulation of the left vagus nerve that required cardiopulmonary resuscitation and cardiac massage.


Assuntos
Parada Cardíaca , Toracotomia , Bradicardia/etiologia , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Frequência Cardíaca , Humanos , Toracotomia/efeitos adversos , Nervo Vago
9.
J Cardiothorac Surg ; 16(1): 137, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34020682

RESUMO

BACKGROUND: Cardiac erosion after percutaneous atrial septal defect (ASD) closure is a rare complication that requires immediate life-saving emergency surgery. In this report, we present our successful life-saving strategy for cardiac arrest due to cardiac tamponade caused by erosion 6 years after the percutaneous closure of an ASD. CASE PRESENTATION: The patient was a 50-year-old man who received treatment using an Amplatzer septal occluder (St. Jude Medical, St. Paul, MN, USA) treatment for ostium secundum atrial septal defect (size: 29.5 × 27.0 mm) at another institution when he was 44 years old. CONCLUSIONS: This case report presents a bailout surgical strategy for patients who are hemodynamically unstable with risks of coagulopathy and multiple organ failure. This case shows that cardiac surgeons need to be aware of percutaneous ASD-closure complications and should consider a bailout surgical strategy for patients at risk of multiple organ failure.


Assuntos
Tamponamento Cardíaco/cirurgia , Parada Cardíaca/cirurgia , Dispositivo para Oclusão Septal/efeitos adversos , Adulto , Tamponamento Cardíaco/etiologia , Parada Cardíaca/etiologia , Comunicação Interatrial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia
12.
Scand J Trauma Resusc Emerg Med ; 29(1): 58, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33849626

RESUMO

A 3 month old boy, with no known health conditions, suffered a sudden collapse at home. On first EMS arrival, ventricular fibrillation (VF) cardiac arrest was identified and resuscitation following UK national guidelines was initiated. He remained in cardiac arrest for over 25 min, during which he received 10 defibrillation shocks, each effective, but with VF reoccurring within a few seconds of each of the first 9. A return of spontaneous circulation (ROSC) was achieved after the 10th shock. The resuscitation was conducted fully in his home, with the early involvement of Advanced Paramedic Practitioners specialising in critical care (APP- CC). Throughout his resuscitation, there remained a strong focus on delivering quality resuscitation in situ, rather than a 'load and go' approach that would have resulted in very early conveyance to hospital with on-going CPR.The patient was subsequently discharged home and is making an excellent recovery. The arrest was later determined to have been caused by a primary arrhythmia as a result of a previously unidentified non-obstructive variant hypertrophic cardiomyopathy.We present data downloaded from the defibrillator used during the resuscitation that illustrates clearly the recurrent nature of his fibrillation.


Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Parada Cardíaca Extra-Hospitalar/terapia , Fibrilação Ventricular/complicações , Cardioversão Elétrica/métodos , Parada Cardíaca/etiologia , Humanos , Lactente , Masculino , Parada Cardíaca Extra-Hospitalar/etiologia , Fatores de Tempo
13.
Toxicon ; 197: 65-69, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-33872678

RESUMO

Mushroom poisoning is a common clinical problem. Severe mushroom poisoning often causes liver and kidney failure. Although severe myocardial damage is rare, the fatality rate is extremely high. This case report describes a 56-year-old male suffered severe myocardial damage, multiple organ dysfunction, circulatory failure, recurrent malignant arrhythmia, and cardiac arrest after the ingestion of wild mushrooms. He was administered venoarterial extracorporeal membrane oxygenation (VA-ECMO) combined with hemoperfusion, plasma exchange and continuous renal replacement therapy. The heart rhythm gradually stabilized 3 hours after ECMO surgery. On the 6th day after ECMO, heart function recovered. The patient was then weaned from ECMO, and he ultimately recovered and was discharged. In patients with fatal mushroom poisoning leading to refractory arrhythmia and cardiac arrest, early implementation of VA-ECMO combined with sequential blood purification treatment can improve the prognosis and increase the survival rate.


Assuntos
Oxigenação por Membrana Extracorpórea , Parada Cardíaca , Intoxicação Alimentar por Cogumelos , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação Alimentar por Cogumelos/complicações , Intoxicação Alimentar por Cogumelos/terapia
14.
Medicine (Baltimore) ; 100(17): e25698, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907149

RESUMO

RATIONALE: Peripheral nerve injury related to vascular complications associated with extracorporeal membrane oxygenation (ECMO) is perhaps underappreciated. Compared to the well-described central nervous system complications of ECMO, brachial plexopathy and lumbosacral plexopathy have rarely been reported. We report this case to heighten awareness of lumbosacral plexus injury due to pelvic hematoma formation after ECMO. PATIENT CONCERNS: A 53-year-old woman developed a large pelvic hematoma with significant mass effect on intrapelvic structures after receiving lifesaving venoarterial ECMO for cardiogenic shock following a cardiac arrest. During her hospital course, she developed bilateral foot drop that was attributed to critical illness. Her lack of neurological recovery after 6 months prompted referral to neuromuscular medicine for consultation. DIAGNOSIS: The patient was retrospectively diagnosed with bilateral lumbosacral plexopathy due to the large pelvic hematoma. INTERVENTION: Electromyography/nerve conduction study (EMG/NCS) obtained at the time of referral to neuromuscular medicine localized her neurological deficits to the bilateral lumbosacral plexus and demonstrated no volitional motor unit action potentials in her lower leg muscles. OUTCOMES: The patient had minimal recovery of strength at the level of the ankles but was ambulatory with solid ankle-foot orthoses due to spared proximal lower extremity strength. Unfortunately, the absence of any volitionally activated motor unit action potentials in her lower leg muscles on EMG performed 6 months after the initial injury was a poor prognostic indicator for successful reinnervation and future neurological recovery. LESSONS: Neurological deficits occurring during the course of administration of ECMO require accurate localization. Neurology consultation and/or EMG/NCS may be useful if localization is not clear. Lesions localizing to the lumbosacral plexus should prompt radiographic evaluation with computed tomography of the abdomen and pelvis. Hemostasis of a retroperitoneal hematoma may be achieved with embolization. However, if neurological deficits do not improve, surgical consultation for hematoma evacuation may be warranted.


Assuntos
Oxigenação por Membrana Extracorpórea , Parada Cardíaca/cirurgia , Hematoma , Plexo Lombossacral/lesões , Pelve , Traumatismos dos Nervos Periféricos , Neuropatias Fibulares , Estado Terminal/terapia , Eletromiografia/métodos , Oxigenação por Membrana Extracorpórea/efeitos adversos , Oxigenação por Membrana Extracorpórea/métodos , Feminino , Parada Cardíaca/etiologia , Hematoma/complicações , Hematoma/fisiopatologia , Humanos , Pessoa de Meia-Idade , Condução Nervosa , Pelve/irrigação sanguínea , Pelve/patologia , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/fisiopatologia , Neuropatias Fibulares/diagnóstico , Neuropatias Fibulares/etiologia , Neuropatias Fibulares/fisiopatologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Prognóstico , Choque Cardiogênico/complicações
16.
Medicine (Baltimore) ; 100(15): e25519, 2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33847671

RESUMO

RATIONALE: Cardiac arrest caused by water intoxication syndrome following hysteroscopic surgery is a rare but life-threatening occurrence. Extracorporeal membrane oxygenation (ECMO) is rarely used to treat water intoxication syndrome in hysteroscopic surgery. Here, we successfully treated a patient with water intoxication syndrome following hysteroscopic surgery with ECMO. PATIENT CONCERNS: We report a rare case of cardiac arrest during hysteroscopic surgery treated with veno-venous (VV) ECMO. DIAGNOSIS: Water poisoning syndrome was diagnosed by electrolyte examination, the lowest value of serum sodium was 110.7 mmol/L. INTERVENTIONS: VV-ECMO was prescribed as a measure after traditional cardiopulmonary resuscitation. RESULTS: ECMO was successfully evacuated on day 5 and the patient was discharged on day 45. CONCLUSION: Mastering the hysteroscopic operative techniques and using a bipolar hysteroscopic generator, isotonic fluid, perfusion pressures less than 100 mm Hg, and local anesthesia may reduce the risk of hysteroscopic water intoxication syndrome. During hysteroscopic surgery, patients may experience cardiac arrest and fatal water intoxication syndrome. Even when traditional cardiopulmonary resuscitation is successful, VV ECMO may contribute to the recovery of brain function if oxygenation is not maintained.


Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Parada Cardíaca/terapia , Histeroscopia/efeitos adversos , Complicações Pós-Operatórias/terapia , Intoxicação por Água/terapia , Adulto , Reanimação Cardiopulmonar/métodos , Feminino , Parada Cardíaca/etiologia , Humanos , Leiomioma/cirurgia , Ilustração Médica , Complicações Pós-Operatórias/etiologia , Neoplasias Uterinas/cirurgia , Intoxicação por Água/etiologia
17.
Medicine (Baltimore) ; 100(15): e25522, 2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33847673

RESUMO

RATIONALE: Severe methemoglobinemia (Met-Hb) is rare. The delayed diagnosis and treatment often cause further damage. The management of cellular hypoxemia is challenging and the use of extra-corporeal membrane oxygenation (ECMO) has never been reported. PATIENT CONCERNS: The young patient, healthy with unremarkable past medical history, was sent to emergency room with out-of-hospital circulatory arrest (OHCA) and severe generalized cyanosis. His family reported he ingested sodium nitrite accidentally. DIAGNOSES: After successful resuscitation and return of spontaneous circulation (ROSC), the paradoxically normal arterial blood gas (ABG) with the unusual brownish blood led to the suspicion of Met-Hb. The lab test confirmed it and showed a very high level of 80%. INTERVENTIONS: Because of recovered and normal cardiac function, we placed veno-venous extracorporeal membrane oxygenation (VV-ECMO) for tissue hypoxemia in addition to exchange transfusion, vitamin C, and methylene blue. OUTCOMES: Met-Hb blood level dropped rapidly. After vigorous rehabilitation for weeks, the patient was able to be discharged home without major neurological sequela. LESSONS: VV-ECMO can hyper-oxygenate the hypoxemic tissue regardless the etiology and minimize hypoxemia-reperfusion injury while awaiting the definite diagnosis and therapy.


Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Parada Cardíaca/diagnóstico , Parada Cardíaca/terapia , Metemoglobinemia/diagnóstico , Metemoglobinemia/terapia , Diagnóstico Diferencial , Parada Cardíaca/etiologia , Humanos , Masculino , Metemoglobinemia/complicações , Adulto Jovem
18.
Rev Port Cir Cardiotorac Vasc ; 28(1): 59-60, 2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33834649

RESUMO

INTRODUCTION: Congenital chest wall deformities are common in children, causing self and parental concern mainly due to cosmesis. These defects rarely cause severe symptoms in patients. CASE REPORT: 11-year-old girl with a complex chest wall deformity and severe scoliosis causing progressive neurological loss of function. When mobilized to prone position for orthopedic surgery, she suffered sudden hypotension immediately followed by a cardiac arrest, that reverted after moving the child back to supine position. The cardiac arrest was interpreted as a result of a decrease in venous blood return secondary to heart and great vessels compression. She was then proposed and submitted to a modified Ravitch procedure with retrosternal metal bar placement in order to allow ventral positioning. This was successfully achieved, and the patient underwent scoliosis correction 3 months later. After more than a year of follow up, she reduced the need for non-invasive ventilation and tolerates prone positioning. CONCLUSION: This case report alerts medical community that beyond cosmesis concerns, severe chest wall deformities can cause life-threatening events if not correctly managed.


Assuntos
Parada Cardíaca , Parede Torácica , Criança , Feminino , Parada Cardíaca/etiologia , Humanos , Parede Torácica/diagnóstico por imagem
19.
BMJ Case Rep ; 14(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33858885

RESUMO

A 38-year-old man previously healthy suffered an out-of-hospital cardiac arrest; he was resuscitated successfully and admitted to the intensive care unit. His initial ECG suggested a Brugada pattern; other laboratory tests revealed low potassium level, low Thyroid Stimulating Hormone (TSH) and high FT4. He was started on carbimazole for hyperthyroidism, along with other supportive care. A comprehensive cardiac evaluation was done, including ajmaline and flecainide tests, results were inconclusive. An implantable cardioverter defibrillator device (ICD) was inserted to prevent such catastrophic events in the future. After discharge and on follow-up, our patient was doing well. His thyroid function test (TFT) was normal; moreover, a follow-up ICD interrogation did not record any arrhythmias. This case report highlighted asymptomatic hyperthyroidism as a precipitant for Brugada pattern resulting in sudden cardiac arrest.


Assuntos
Síndrome de Brugada , Desfibriladores Implantáveis , Parada Cardíaca , Hipertireoidismo , Adulto , Síndrome de Brugada/complicações , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/terapia , Morte Súbita Cardíaca , Eletrocardiografia , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Humanos , Hipertireoidismo/complicações , Hipertireoidismo/diagnóstico , Hipertireoidismo/tratamento farmacológico , Masculino
20.
Medicina (Kaunas) ; 57(4)2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33804853

RESUMO

INTRODUCTION: Substernal goiter is usually defined as a goiter that extends below the thoracic inlet or a goiter with more than 50% of its mass lying below the thoracic inlet. Substernal goiters may compress adjacent anatomical structures causing a variety of symptoms. CASE REPORT: Here we report a rare case of a 75-year-old woman presenting with cardiac arrest caused by acute respiratory failure due to tracheal compression by a substernal goiter. DISCUSSION: Substernal goiters can be classified as primary or secondary depending on their site of origin. Symptoms are diverse and include a palpable neck mass, mild dyspnea to asphyxia, dysphagia, dysphonia, and superior vena cava syndrome. Diagnosis of substernal goiter is largely based on computed tomography imaging, which will show the location of the goiter and its extension in the thoracic cavity. Surgery is the treatment of choice for symptomatic patients with substernal goiter. The majority of substernal goiters are resected through a cervical approach. However, in approximately 5% of patients, a thoracic approach is required. The most important factor determining whether a thoracic approach should be used is the depth of the extension to the tracheal bifurcation on CT imaging. CONCLUSION: Cardiac arrest appearing as the first symptom of a substernal goiter is a very rare condition and should be treated by emergency thyroidectomy via a cervical or thoracic approach depending on the CT imaging findings.


Assuntos
Bócio Subesternal , Parada Cardíaca , Síndrome da Veia Cava Superior , Idoso , Feminino , Bócio Subesternal/complicações , Bócio Subesternal/diagnóstico por imagem , Bócio Subesternal/cirurgia , Parada Cardíaca/etiologia , Humanos , Estudos Retrospectivos , Esternotomia , Tireoidectomia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...