DOI: 10.36347/sjmcr.2016.v04i05.006

Pages: 302-305

A 49-year-old woman presented with palpitations. She had a uterine myoma but she had not received any treatment for it. One day before she arrived at our hospital, she visited a local clinic. The physician there could not detect any significant abnormalities. The next day, she experienced palpitations and shortness of breath on standing after lunch and called an ambulance. When the emergency medical technician checked her, she complained of dyspnea with shocked vital signs. After accommodation in the ambulance, she entered cardiac arrest with pulseless electrical activity. Upon arrival, she remained in a state of cardiopulmonary arrest. During cardiopulmonary resuscitation, she underwent a Rapid Ultrasound in a SHock (RUSH) examination, and a D-shaped LV with a snowstorm pattern with a dilated inferior vena cava and massive uterine myoma were observed. Postmortem plain CT revealed no other remarkable findings related to her death. Her D-dimer level was 16.7 μg/ml. She was diagnosed with a pulmonary embolism.The inferior vena cava and/or the iliac vein by the massive uterine myoma was suspected to have been the cause of the embolism. Our findings in the present case suggest that using ultrasonography during cardiopulmonary arrest is indeed useful for detecting the cause of cardiac arrest.