This is a review of clinical characteristics in 25 dissecting aortic aneurysm patients and 26 pulmonary embolism patients with the association of cardiac arrest and an electrocardiogram simulating ST elevation myocardial infarction (STEMI). Cases were culled from anecdotal reports dating from January 2000 to February 2020 using Pubmed, MEDLINE, EMBASE, and Googlescholar. Search terms were dissecting aortic aneurysm, pulmonary embolism, myocardial infarction, and ST segment elevation. Cases were included only if there was a specification of location of ST segment elevation and an account of presenting symptoms. Fifteen of the 25 dissecting aortic aneurysm patients were also evaluated by transthoracic echocardiography, which showed stigmata of aortic dissection in eleven. Ventricular tachyarrhythmia was the single most common electrocardiographic component of the cardiac arrest. There were 11 survivors. There were 26 cardiac arrest cases associated with pulmonary embolism, 17 of whom were evaluated by transthoracic echocardiography, which documented right ventricular dilatation in sixteen. Pulseless electrical activity was the single most common electrocardiographic component of the cardiac arrest. Thirteen pulmonary embolism patients received some form of thrombolytic treatment. Three were managed by surgical embolectomy. There were 12 survivors.
Patients were also categorised into those who were fast-tracked to percutaneous coronary intervention and those who were not. In the pulmonary embolism subgroup, those who had presented with chest pain were significantly (P=0.047) more likely to have been fast tracked to percutaneous coronary intervention.
cardiac; arrest;aorticdissection;pulmonary;embolism