Out of hospital cardiac arrests and aortic dissection
DOI:
https://doi.org/10.48750/acv.498Keywords:
Out of Hospital Cardiac Arrest, Aortic Dissection, Review [Publication Type]Abstract
INTRODUCTION: Out of Hospital Cardiac Arrest (OHCA) is one of the main causes of death worldwide. Most of the intrinsic causes of OHCA tend to be of cardiac origin, however, non-cardiac etiologies such as acute aortic dissection (AAD) may be more common than previously thought. The aim of this focused review is to summarize current knowledge on the association between OHCA and AAD.
METHODS: A systematic review was previously performed on the incidence of AAD in the context of OHCA. For this publication, the selected references were reviewed to address three pre-determined questions: 1) How prevalent is Acute Aortic Dissection in Patients presenting with Out of Hospital Cardiac Arrest? 2) What clinical signs are associated with OHCA due to Acute Aortic Dissection? 3) How can we treat these patients and what is their prognosis?
RESULTS: AAD may cause OHCA due to several reasons, such as retrograde involvement of the coronary arteries, aortic valve insufficiency, pericardium tamponade, aortic rupture, massive stroke, visceral malperfusion or hypertensive induced heart failure, for example. Since both the treatment and diagnosis of acute aortic dissections have improved, a growing number of OHCA due to AAD patients have been diagnosed and managed, however, the epidemiology and outcomes of these patients are still not fully understood.
Downloads
References
Myat A, Song KJ, Rea T. Out-of-hospital cardiac arrest: current concepts. Lancet. 2018;391:970-9
Atwood C, Eisenberg MS, Herlitz J, Rea TD. Incidence of EMS-treated out- of-hospital cardiac arrest in Europe. Resuscitation. 2005;67:75-80
Takeuchi S, Yamaguchi Y, Soejima K, Yoshino H. Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography. Eur Heart J Acute Cardiovasc Care. 2020;9(3_suppl):S48-57
Melo RG, Machado C, Caldeira D, Alves M, Lopes A, Serrano M, et al. Incidence of acute aortic dissections in patients with out of hospital cardiac arrest: A systematic review and meta-analysis of observational studies. Int J Cardiol Heart Vasc. 2021;38:100934
Moriwaki Y, Tahara Y, Kosuge T, Suzuki N. Etiology of out-of-hospital cardiac arrest diagnosed via detailed examinations including perimortem computed tomography. J Emerg Trauma Shock. 2013;6:87-9.
Meyer L, Stubbs B, Fahrenbruch C, Maeda C, Harmon K, Eisenberg M, et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review. Circulation. 2012;126:1363-72
Nakai C, Izumi S, Haraguchi T, Kikuta S, Nakayama S, Okita Y, et al. Acute Type A Aortic Dissection With Cardiopulmonary Arrest at Presentation. Ann Thorac Surg. 2021;112:1210-6
Melo RG, Mourão M, Caldeira D, Alves M, Lopes A, Duarte A, et al. A systmatic review and meta-analysis of the incidence of acute aortic dissections in population-based studies. J Vasc Surg. 2022;75:709-20
Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897-903
Pape LA, Awais M, Woznicki EM, Suzuki T, Trimarchi S, Evangelista A, et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015;66:350-8
Kim YW, Jung WJ, Cha KC, Roh YI, Kim YS, Kim OH, et al. Diagnosis of aortic dissection by transesophageal echocardiography during cardiopulmonary resuscitation. Am J Emerg Med. 2021;39:92-5
Levy AD, Harcke HT, Mallak CT. Postmortem imaging: MDCT features of postmortem change and decomposition. Am J Forensic Med Pathol. 2010;31:12-7
Roberts IS, Benamore RE, Benbow EW, Lee SH, Harris JN, Jackson A, et al. Post-mortem imaging as an alternative to autopsy in the diagnosis of adult deaths: a validation study. Lancet. 2012;379:136-42
Otani T, Ichiba T, Kashiwa K, Naito H. Potential of unenhanced computed tomography as a screening tool for acute aortic syndromes. Eur Heart J Acute Cardiovasc Care. 2021;10:967-75
Kurabayashi M, Okishige K, Ueshima D, Yoshimura K, Shimura T, Suzuki H, et al. Diagnostic utility of unenhanced computed tomography for acute aortic syndrome. Circ J. 2014;78:1928-34
Zhu Y, Lingala B, Baiocchi M, Tao JJ, Toro Arana V, Khoo JW, et al. Type A Aortic Dissection-Experience Over 5 Decades: JACC Historical Breakthroughs in Perspective. J Am Coll Cardiol. 2020;76:1703-13
Tanaka Y, Sakata K, Sakurai Y, Yoshimuta T, Morishita Y, Nara S, et al. Prevalence of Type A Acute Aortic Dissection in Patients With Out-Of- Hospital Cardiopulmonary Arrest. Am J Cardiol. 2016;117:1826-30
Jitsuiki K, Ishikawa K, Nagasawa H, Takeuchi I, Iso T, Kondo A, et al. Clinical profile of patients with cardiac arrest induced by aortic disease. Resuscitation. 2017;120:e1.
SOS‐KANTO 2012 Study Group, Inokuchi S, Masui Y, Miura K, Tsutsumi H, Takuma K, et al. Investigation and treatment of pulmonary embolism as a potential etiology may be important to improve post-resuscitation prognosis in non-shockable out-of-hospital cardiopulmonary arrest: report on an analysis of the SOS-KANTO 2012 study. Acute Med Surg. 2016;3:250-9
Kobayashi N, Hata N, Shimura T, Yokoyama S, Shirakabe A, Shinada T, et al. Characteristics of patients with cardiac arrest caused by coronary vasospasm. Circ J. 2013;77:673-8
Kinoshita T, Yamakawa K, Matsuda H, Yoshikawa Y, Wada D, Hamasaki T, et al. The Survival Benefit of a Novel Trauma Workflow that Includes Immediate Whole-body Computed Tomography, Surgery, and Interventional Radiology, All in One Trauma Resuscitation Room: A Retrospective Historical Control Study. Ann Surg. 2019;269:370-6
The founding members of the Japanese Association for Hybrid Emergency Room System (JA‐HERS). The hybrid emergency room system: a novel trauma evaluation and care system created in Japan. Acute Med Surg. 2019;6:247-51
Umemura Y, Watanabe A, Kinoshita T, Morita N, Yamakawa K, Fujimi S. Hybrid emergency room shows maximum effect on trauma resuscitation when used in patients with higher severity. J Trauma Acute Care Surg. 2021;90:232-9
Kinoshita T, Moriwaki K, Hanaki N, Kitamura T, Yamakawa K, Fukuda T, et al. Cost-effectiveness of a hybrid emergency room system for severe trauma: a health technology assessment from the perspective of the third-party payer in Japan. World J Emerg Surg. 2021;16:2
Ito K, Nagao T, Tsunoyama T, Kono K, Tomonaga A, Nakazawa K, et al. Hybrid emergency room system improves timeliness of angioembolization for pelvic fracture. J Trauma Acute Care Surg. 2020;88:314-9
Umemura Y, Watanabe A, Kinoshita T, Morita N, Yamakawa K, Fujimi S. Hybrid emergency room shows maximum effect on trauma resuscitation when used in patients with higher severity. J Trauma Acute Care Surg. 2021;90:232-9
Watanabe H, Matsumoto R, Kuramoto S, Muronoi T, Oka K, Shimojo Y, et al. Hybrid emergency rooms reduce the requirement of blood transfusion in patients with severe trauma. World J Emerg Surg. 2021;16:34
Kirkpatrick AW, Vis C, Dubé M, Biesbroek S, Ball CG, Laberge J, et al. The evolution of a purpose designed hybrid trauma operating room from the trauma service perspective: the RAPTOR (Resuscitation with Angiography Percutaneous Treatments and Operative Resuscitations). Injury. 2014;45:1413-21
Loftus TJ, Croft CA, Rosenthal MD, Mohr AM, Efron PA, Moore FA, et al. Clinical Impact of a Dedicated Trauma Hybrid Operating Room. J Am Coll Surg. 2021;232:560-70
