Oral contraceptive pills - a phantom menace: the case of a healthy young woman who presented with cardiac arrest due to a pulmonary em-bolism and coronary artery thrombus

Authors

  • Thanat Tangpaisarn Department of Emergency Medicine, Faculty of Medicine Srinakarind Hospital, Khon Kaen University
  • Praew Kotruchin Department of Emergency Medicine, Faculty of Medicine Srinakarind Hospital, Khon Kaen University
  • Burabha Pussadhamma Department of Internal Medicine, Faculty of Medicine Srinakarind Hospital, Khon Kaen University

Keywords:

Acute pulmonary embolism, Acute coronary syndrome, Sudden cardiac arrest

Abstract

We encountered a 33-year-old woman, who had taken oral contraceptive pills (OCPs) for a month before she had cardiac arrest. After she had received resuscitation and had returned to spontaneous circulation (ROSC), right ventricular dilatation with LV septal wall flattening was detected by bedside cardiac ultrasound. Acute pulmonary embolism (PE) was initially suspected and was confirmed by Invasive pulmonary angiogram. Unfortunately, after intra-lesional thrombolysis and clot aspiration had been performed, the patient’s condition improved, but later on worsened. An electrocardiogram (ECG) showed ST-segment elevation at the inferior wall territory. Coronary angiogram (CAG) was performed and a right coronary artery thrombus was found. Despite thorough blood tests investigations, we did not find any other risk of thrombosis other than OCPs.

References

Margey R, Roy A, Tobin S, O’Keane CJ, Mc Gorrian C, Morris V, et al. Sudden cardiac death in 14- to 35-year olds in Ireland from 2005 to 2007: a retrospective registry.Eur Eur Pacing Arrhythm Card Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol. 2011;13(10):1411–8.

Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM, et al. Sudden death in young adults: an autopsybased series of a population undergoing active surveillance. J Am Coll Cardiol. 2011;58(12):1254–61.

Kürkciyan I, Meron G, Sterz F, Janata K, Domanovits H, Holzer M, et al. Pulmonary embolism as a cause of cardiac arrest: presentation and outcome. Arch Intern Med. 2000 ;160(10):1529–35.

Sakuma M, Nakamura M, Takahashi T, Kitamukai O, Yazu T, Yamada N, et al. Pulmonary embolism is an important cause of death in young adults. Circ J Off J Jpn Circ Soc. 2007 ;71(11):1765–70.

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543–603.

Downloads

Published

2021-07-08

How to Cite

1.
Tangpaisarn T, Kotruchin P, Pussadhamma B. Oral contraceptive pills - a phantom menace: the case of a healthy young woman who presented with cardiac arrest due to a pulmonary em-bolism and coronary artery thrombus. TJEM [Internet]. 2021 Jul. 8 [cited 2024 Dec. 22];3(1):71-9. Available from: https://he02.tci-thaijo.org/index.php/TJEM/article/view/249125