Key result
Focused transthoracic echocardiography was critical in diagnosing previously unrecognized pulmonary hypertension in a patient who suffered cardiac arrests during emergent thoracic surgery.
Case Report (n=1)
Focused cardiac ultrasound is a critical tool for diagnosing the cause of cardiovascular collapse, such as undiagnosed pulmonary hypertension, during noncardiac surgery.
May support focused TTE for unexplained perioperative arrest; hypothesis-generating without prospective validation.
Patients with severe pulmonary hypertension (PHT) represent a high-risk population when undergoing noncardiac surgery. During thoracic surgery with 1-lung ventilation, atelectasis of the operative lung, and frequently associated hypoxemia, is likely to exacerbate PHT and precipitate acute right ventricular failure. We present a patient with previously undiagnosed PHT who suffered 2 cardiac arrests during emergent thoracic surgery for empyema. After successful resuscitation in the operating room, she subsequently required prolonged venoarterial extracorporeal membrane oxygenation. Focused transthoracic echocardiography to evaluate cardiac function was critical in the diagnosis of PHT and subsequent treatment with sildenafil and nifedipine when discharged from the hospital.
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Ironfield et al. (2018) conducted a case report in Undiagnosed pulmonary hypertension undergoing emergent thoracic surgery for empyema (n=1). Focused transthoracic echocardiography was evaluated on Diagnosis of pulmonary hypertension. Focused transthoracic echocardiography was critical in diagnosing previously unrecognized pulmonary hypertension in a patient who suffered cardiac arrests during emergent thoracic surgery.
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