Cardiac Arrest Due to Air Embolism: Complicating Image-guided Lung Biopsy

Zaineb Viqas,Maria Yaseen,Allah Yar,Muhammad Khalid

doi:10.7759/cureus.3295

Abstract

Cardiac arrest due to air embolism is an infrequent complication. Air embolism can be associated with procedures like endoscopic retrograde cholangiopancreatography, endoscopic variceal ligation, operative hysteroscopy, laparoscopic surgery, pacemaker placement, cardiac ablation, fiberoptic bronchoscopy, and decompression sickness. In rare cases, air embolus can be a catastrophic complication of computed tomography (CT) guided lung biopsy, which can lead to cardiac arrest. We present a case of a 67-year-old male chronic smoker with a left lower lobe pulmonary nodule who had a cardiac arrest due to air embolism as a consequence of CT guided biopsy of the pulmonary nodule found on a CT scan of the chest. He was successfully resuscitated and intubated for mechanical ventilation. He was managed conservatively and discharged home in a stable condition.

Highlights

Air embolism is an uncommon but potentially catastrophic event that occurs as a consequence of entry of air into the vasculature
We present a case of cardiac arrest from air embolism in the left ventricle following fine needle lung biopsy
A 67-year-old male chronic smoker with medical history significant for chronic obstructive pulmonary disease was admitted for imaging guided biopsy of a 1.2 cm left lower lobe lung nodule found recently on a computed tomography (CT) scan of the chest

Summary

Introduction

Air embolism is an uncommon but potentially catastrophic event that occurs as a consequence of entry of air into the vasculature. We present a case of cardiac arrest from air embolism in the left ventricle following fine needle lung biopsy. How to cite this article Viqas Z, Yar A, Yaseen M, et al (September 13, 2018) Cardiac Arrest Due to Air Embolism: Complicating Image-guided Lung Biopsy. He was successfully resuscitated and intubated for mechanical ventilation. A CT scan of the chest was obtained immediately after the resuscitation and it demonstrated development of a small anechoic area in the left cardiac ventricle consistent with air embolus (Figure 1). The patient remained hemodynamically stable for 24 hours, and he was successfully weaned off from the mechanical ventilator day and discharged home in a stable condition

Discussion

Conclusions

Disclosures