Caseous calcification of the mitral annulus in a cardiac arrest survivor

AbstractDuring the last two decades, survival rates after cardiac arrest have increased while the fraction of patients surviving with a severe neurological disability or vegetative state has decreased in many countries. While improved survival is due to improvements in the whole “chain of survival,” improved methods for prognostication of neurological outcome may be of major importance for the lower disability rates. Patients who are resuscitated and treated in intensive care will die mainly from the withdrawal of life-sustaining (WLST) therapy due to presumed poor chances of meaningful neurological recovery. To ensure high-quality decision-making and to reduce the risk of premature withdrawal of care, implementation of local protocols is crucial and should be guided by international recommendations. Despite rigorous neurological prognostication, cognitive impairment and related psychological distress and reduced participation in society will still be relevant concerns for cardiac arrest survivors. The commonly used outcome measures are not designed to provide information on these domains. Follow-up of the cardiac arrest survivor needs to consider the cardiovascular burden as an important factor to prevent cognitive difficulties and future decline.

Download Full-text

Abstract 18294: Left Ventricular Systolic Dysfunction Early After Resuscitation From Cardiac Arrest is Associated With Shockable Arrest Rhythm

Circulation ◽

10.1161/circ.132.suppl_3.18294 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Jacob C Jentzer ◽

Hussein Abu-Daya ◽

Asher Shafton ◽

Meshe Chonde ◽

Didier Chalhoub ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Mortality ◽

Troponin I ◽

Left Ventricular Systolic Dysfunction ◽

Systolic Dysfunction ◽

Mitral Annulus ◽

Left Ventricular ◽

Ventricular Systolic Dysfunction ◽

Mitral Annulus Velocity ◽

Fractional Shortening

Introduction: Left ventricular systolic dysfunction (LVSD) is common after resuscitation from cardiac arrest (CA). The association of echocardiographic LVSD with cardiac rhythm during CA is not well described. Hypothesis: Patients with a shockable rhythm (VT/VF) will have a greater degree of LVSD by echocardiography after CA. Methods: Prospective registry of patients resuscitated from CA underwent transthoracic echocardiography (TTE) within 24 hours after CA. We determined 2D measurements, LVEF, spectral Doppler of mitral inflow and LV outflow, systolic and diastolic tissue Doppler of the mitral annulus velocity, and tricuspid plane annular excursion (TAPSE). We collected data on in-hospital mortality as well as vasopressor doses and troponin I levels. TTE parameters and clinical characteristics were compared between patients with a shockable (VT/VF) arrest rhythm and a non-shockable (asystole/PEA) arrest rhythm and between survivors and non-survivors using t-tests and ANOVA. Results: Of the 55 patients, the 23 (42%) with shockable CA rhythms had significantly higher LV end-systolic dimension (4.1cm vs. 3.3cm, p = 0.0073), lower LV fractional shortening (0.15 vs. 0.28, p <0.0001), and lower LVEF both by visual estimate (36.2% vs. 52.3%, p = 0.0012) and by Simpson’s biplane method (37.5% vs. 52.3%, p = 0.0506). Other measured TTE parameters did not differ between groups, including TAPSE (shockable 1.53 vs. non-shockable 1.82, p = 0.1731). Admission and peak 24 hour vasopressor requirements did not differ between groups. Peak troponin levels were higher (22.26 vs. 3.88, p = 0.0198) in patients with shockable CA rhythms, but admission troponin levels were no different (0.88 vs. 0.51, p = 0.1527). TTE parameters did not differ between survivors and non-survivors (visual LVEF 47.0% vs. 44.2%, p = 0.5968; LV fractional shortening 0.19 vs. 0.25, p = 0.0916). Conclusions: Patients with shockable CA rhythms have more severe LVSD on 24 hour echocardiography despite similar vasopressor requirements and admission troponin levels. Echocardiographic parameters at 24 hours did not predict in-hospital mortality. Early echocardiography after CA appears more useful for differentiating primary CA rhythm than for predicting mortality.

Download Full-text

Cardiac Arrest Survivor Reunion

The Internet Journal of Rescue and Disaster Medicine ◽

10.5580/a9 ◽

2000 ◽

Vol 2 (1) ◽

Keyword(s):

Cardiac Arrest ◽

Cardiac Arrest Survivor

Download Full-text

Right Coronary Dissection and Left Anterior Thrombus: Dual Dilemma in a Young Cardiac Arrest Survivor

Heart Lung and Circulation ◽

10.1016/j.hlc.2016.06.063 ◽

2016 ◽

Vol 25 ◽

pp. S28

Author(s):

H. Morgan ◽

M. McCann ◽

R. Clugston ◽

A. Wheelan

Keyword(s):

Cardiac Arrest ◽

Cardiac Arrest Survivor

Download Full-text

Long-term survivors of cardiac arrest: A narrative inquiry

European Journal of Cardiovascular Nursing ◽

10.1177/1474515119844717 ◽

2019 ◽

Vol 18 (6) ◽

pp. 458-464 ◽

Cited By ~ 4

Author(s):

Gunilla Haydon ◽

Pamela van der Riet ◽

Kerry Inder

Keyword(s):

Cardiac Arrest ◽

Narrative Inquiry ◽

Positive Attitude ◽

Loss Of Control ◽

Cardiac Health ◽

Cardiac Arrest Survivor ◽

Long Term Survivors

Background: Despite extensive knowledge and research in cardiac health there is limited understanding in how a cardiac arrest influences the life of long-term survivors. Objective: The aim of this study was to explore how long-term survivors of a cardiac arrest adjusted to their new reality, expressed in their re-storied narratives. Methods: Seven individuals surviving a cardiac arrest 5–26 years ago were interviewed through in-depth conversations over a six-month period. These interviews were analysed using Clandinin and Connelly’s framework of narrative inquiry. Results: Seven threads were found: Disbelief, Surveillance of their body, Loss of control and desire for normality, Keeping fit and informing others, Gratefulness, Spirituality – luck and fate, and Fragility of life and dying. Conclusions: All seven long-term survivors of cardiac arrest expressed a positive attitude. Despite the nature of the cardiac arrest and the hurdles that followed, they have a heightened appreciation for life. This indicates that after the adaptation to their new reality of being a cardiac arrest survivor life returns to a new normality.

Download Full-text