Right ventricular blowout rupture complicating cardiopulmonary resuscitation in a patient with acute pulmonary embolism

Just 28 min after the collapse, the patient deteriorated to pulseless electrical activity, and manual cardiopulmonary resuscitation (CPR) was initiated. The possible mechanism of the right ventricular rupture in this case was the increase in intracardiac pressure due to chest compression in the setting of acute massive pulmonary embolism.2 3 Direct compression of the right heart during chest compression, concurrent with the obstruction of right ventricular outflow due to giant thrombi, may produce excessive intracardiac pressure. Circulation 1976; 53: 562–4. doi:10.1161/01.CIR.53.3.562 http://www.ncbi.nlm.nih.gov/pubmed/1248089 4 Kempen PM, Allgood R. Right ventricular rupture during closed-chest cardiopulmonary resuscitation after pneumonectomy with pericardiotomy: a case report.