Chest
Volume 97, Issue 2, February 1990, Pages 485-486
Journal home page for Chest

Rhabdomyolysis and Myoglobinuric Renal Failure following Cardioversion and CPR for Acute MI

https://doi.org/10.1378/chest.97.2.485Get rights and content

A 50-year-old man suffered an MI with VFIB at work, and efforts at resucitation were initiated immediately. Ninety minutes of CPR and 14 cardioversions were given by trained personnel before VFIB converted to sinus rhythm. Reversible myoglobinuric renal failure ensued, requiring two weeks of hemodialysis. Scanning with technetium-99m pyrophosphate revealed extensive muscle injury in the regions of cardioversion and a large anterolateral MI. Prolonged resucitative efforts involving repeated cardioversion may predispose to myoglobinuric renal failure.

(Chest 1990; 97:485–86)

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

REFERENCES (18)

There are more references available in the full text version of this article.

Cited by (0)

View full text