Introduction. Pulmonary embolism as a possible cause of acute heart failure
is a potentially fatal condition that can cause death in all age groups.
Patients successfully resuscitated after cardiac arrest have a high risk of
increased mortality and their poor long?term outcome is often associated with
severe neurological complications. Case Outline. This is a case report of a
67?year?old man after a successful cardiopulmonary resuscitation (CPR) which
was followed by therapeutic hypothermia (TH). The patient visited the
dermatological outpatients? department with clinical presentation of pain and
swelling of the right leg, shortness of breath and chest pain. During
examination the patient lost consciousness, stopped breathing and had cardiac
arrest. ECG was done which registered asystole. We began CPR. After 59
minutes of resuscitation return of heartbeat was achieved. The patient was
transported to the Emergency Department. On admission, after computerized
tomography (CT) of the chest confirmed massive pulmonary embolism (PE), the
patient was administered thrombolytic therapy with Metalyse (tenecteplase)
and anti?coagulation therapy (heparin). After stabilization, therapeutic
hypothermia was applied. Combination of EMCOOLSpad on the chest and abdomen
and cold Ringer lactate 500 ml at 4?C was flushed. Temperature was decreased
to 33?C and kept stabile for 24 hours. After eight days the patient was
conscious with a minimal neurological deficit. Conclusion. As shown in this
case report, and according to the rich experience elsewhere, cooling therapy
after out?of?hospital cardiac arrest and successful CRP may be useful in
preventing neurological complications.
Concomitant usage of thrombolytic therapy and therapeutic hypothermia in case of a sudden cardiac arrest due to massive pulmonary embolism
