Chest
Rhabdomyolysis and Myoglobinuric Renal Failure following Cardioversion and CPR for Acute MI
Section snippets
CASE REPORT
A 50-year-old male mechanic suffered an MI at work, and witnesses initiated CPR immediately. An ambulance arrived within seven minutes, finding the patient in VFIB. Intubation, appropriate pharmocologic measures, and ten unsuccessful attempts at cardioversion followed. The CPR was continued, and the patient was transported by helicopter to Iowa Methodist Medical Center, Des Moines. The patient arrived within 90 minutes of his cardiac arrest, in persistent VFIB. After a 14th attempt at
DISCUSSION
Acute renal failure has been described following electroconvulsive therapy,10 although injury due to lightning has been reported to cause myoglobinuria without renal complications.11 In the case presented herein, several factors may have contributed to the total renal burden of myoglobin, including repeated cardioversion, prolonged CPR, and extensive MI; however, the scan with 99mTc pyrophosphate demonstrated the most marked uptake at the sites of cardioversion, suggesting rhabdomyolysis of
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