A Case of Right Ventricular Rupture During Cardiopulmonary Resuscitation

Right ventricular (RV) rupture secondary to cardiopulmonary resuscitation (CPR) is rare but catastrophic when it occurs. It is associated with significant morbidity and mortality and is more common in closed versus open cardiopulmonary resuscitation. Closed CPR is less favoured in these patients in comparison to open CPR and internal cardiac massage as per the Cardiac Surgery Advanced Life Support (CALS) protocol. The site of RV rupture is an indicator of the mechanism of injury. Early re-sternotomy for internal cardiac massage and re-established cerebral perfusion is indicated to avoid the deleterious effects of CPR such as skeletal injury, rib and sternal fractures or cardiac injury. Possible risk factors of RV rupture may include, small body habitus, inappropriate chest compressions, RV hypertrophy, and cardiomegaly with close proximity to sternum. This is a case report of RV rupture in a patient during CPR following aortic and mitral valve replacement for infective endocarditis.