| Management of cardiac arrest caused by coronary artery spasm: epinephrine/adrenaline versus nitrates. | |
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MedLine Citation:
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PMID: 19486791 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious. METHODS AND RESULTS: A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries. Radiologic imaging revealed a positive methylergonovine maleate (Methergine, Novartis Pharmaceuticals, East Hanover, NJ) test, with subocclusive CAS in several coronary vessels leading to electromechanical dissociation. Cardiopulmonary resuscitation was performed, and intracoronary boluses of isosorbide dinitrate were given to treat CAS. Epinephrine/adrenaline was not administered during resuscitation. Spontaneous circulation was obtained after cardioversion for ventricular fibrillation, and the patient progressively regained consciousness. CONCLUSION: Resuscitation guidelines do not specify the use of trinitrate derivatives in cardiac arrest situations caused by CAS. The pros and cons of the use of nitrates and epinephrine/adrenaline during cardiac arrest caused by CAS are analyzed in this case report. |
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Authors:
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Gabor Kiss; Olivier Corre; Gildas Gueret; Vinh Nguyen Ba; Martine Gilard; Jaques Boschat; Charles Chistian Arvieux |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2008-09-11 |
Journal Detail:
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Title: Heart & lung : the journal of critical care Volume: 38 ISSN: 1527-3288 ISO Abbreviation: Heart Lung Publication Date: 2009 May-Jun |
Date Detail:
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Created Date: 2009-06-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0330057 Medline TA: Heart Lung Country: United States |
Other Details:
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Languages: eng Pagination: 228-32 Citation Subset: AIM; IM |
Affiliation:
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Department of Anaesthesia and Surgical Intensive Care, University Hospital of Brest, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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