• Hjartastopp hjá unglingsstúlku – sjúkratilfelli

      Valentínus Þ. Valdimarsson; Girish Hirlekar; Oddur Ólafsson; Gylfi Óskarsson; Hróðmar Helgason; Sigurður E. Sigurðsson; Hildur Tómasdóttir; Kristján Eyjólfsson; Tómas Guðbjartsson; Department of Anesthesia and Intensive Care, Landspitali University Hospital (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-12)
      Cardiac arrest is rarely seen in children and teenagers. We present a 12-year old girl with cardiac arrest following myocardial infarction, that required prolonged cardiac massage and extracorporeal-membranous-oxygenation (ECMO). At coronary angiography the left main coronary artery (LMCA) was stented for a suspected coronary dissection. The contraction of the heart improved and the ECMO-treatment was discontinued a week later. The patient was discharged home, but six months later a coronary artery bypass surgery was performed for in-stent restenosis. Further work-up with computed tomography (CT) showed that the LMCA originated from the right aortic sinus instead of the the left one. This case demonstrates how life threatening myocardial infarction can be caused by coronary artery anomalies.
    • Mannbjörg á Möðrudal á Fjöllum

      Þórir Svavar Sigmundsson; Bjarni Árnason; Þóra Elísabet Kristjánsdóttir; Vilhjálmur Vernharðsson; Department of Anaesthesia and Critical Care, Karolinska University Hospital, Soina (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-05)
      A 27 year old woman suffered a witnessed cardiac arrest in rural Iceland and regained pulse after one hour's resuscitation. She was transported by an air ambulance to a tertiary medical center in Reykjavik where she was diagnosed with a large pulmonary embolus. After 24 hours therapeutic hypothermia she was rewarmed and extubated two days later. She was discharged from the hospital after two weeks neurologically intact. This case illustrates that even in rural circumstances the chain of survival works if all the links are strong, with early access, early resuscitation and early advanced care.