Spontaneous Artery Dissection: 44-year old female

Female patient went into cardiac arrest at work. She had no prior history of arrest. She was treated with bystander CPR and an AED, remaining in VF cardiac arrest. EMS responded and placed her on the EleGARD System, which they had adopted only 2 weeks prior.  The team performed ACD CPR with a LUCAS 3 series chest compression device with an ITD. She began trying to breath on her own during the CPR effort. After a total of 22 shocks and a timespan of 29 minutes, she regained a pulse. She was found to have a dissected left anterior coronary artery in the cardiac cath lab. It was already starting to heal and there was enough blood flow that she could be cooled down and observed. She was rewarmed 24 hours later and woke up. She was discharged home one week later, completely neurologically intact.

What is remarkable?

Patients with spontaneous dissection of the coronary artery who develop cardiac arrest with refractory VF have a very low chance for survival. This patient survived and was neurologically intact, despite a prolonged resuscitation (<1% of patients getting CPR for >25 minutes ever survive). She was cleared to return to work and school less than a month after her incident.

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