Pulseless electrical activity after induction of anesthesia: A witnessed cardiac rupture

Abstract

Acute ventricularrupture leads to a sudden accumulation of blood in the pericar-dial space, resulting in reduced diastolic filling of the ventriclesand decreased cardiac output. Patients may present with symp-toms of cardiogenic shock or severe cardiovascular collapse. Ina chronic/subacute rupture, the clinical presentations are eithernonspecific or masked by the symptoms of a coexisting MI andcongestive heart failure. The present report is a case of cata-strophic cardiovascular collapse during induction of anesthesiain a patient who had a subacute post-MI left ventricular freewall rupture.