July 2, 1982

Paradoxical Bone Marrow Coronary Embolism Following Cardiopulmonary Resuscitation

Author Affiliations

The Methodist Hospital Brooklyn, NY

JAMA. 1982;248(1):33. doi:10.1001/jama.1982.03330010017021

To the Editor.—  We recently encountered a case of paradoxical embolism that may be of interest to readers of The Journal.

Report of a Case.—  A 72-year-old woman was admitted because of upper abdominal pain of two weeks' duration and oliguria of a few days' duration. She was afebrile and normotensive. Both of the patient's lungs were congested, but her heart and abdomen were unremarkable. The laboratory examination disclosed the following values: hemoglobin, 9.5 g/dL; BUN, 86 mg/dL; serum creatinine, 10 mg/dL; and a moderate amount of hematuria and proteinuria. The clinical diagnosis was nephrotic syndrome. Her central venous pressure ranged from 17 to 25 mm H2O. On the second hospital day, while she was prepared for hemodialysis, cardiac arrest developed, and she was successfully resuscitated by closed-chest cardiac massage. She died two hours later.An autopsy showed the microscopic form of periarteritis nodosa of viscera with the