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June 17, 1974

Hemoglobinuria Following Closed Cardiac Massage

Author Affiliations

LaGuardia Hospital Forest Hills, NY

JAMA. 1974;228(12):1520. doi:10.1001/jama.1974.03230370018006

To the Editor.—  Frank hemoglobunuria as a complication of cardiac massage must be rare. We recently observed this unique (self-limiting) complication after vigorous massage.

Report of a Case.—  A 78-year-old white man suffered a dull, aching, and persistent retrosternal pain for four days. He was in no distress. The blood pressure was 116/70 mm Hg; pulse, 68 beats per minutes and regular. Fundi showed arteriosclerotic changes. Neck veins were flat. The apex of the heart was in the fifth intercostal space in midclavicular line. The sounds were normal. The lungs were clear.Shortly after admission, cardiac arrest occurred. The physician started vigorous closed-chest cardiac massage with a hard board under the patient's mattress. The emergency team arrived within two minutes. An electrocardiographic tracing showed ventricular fibrillation. The patient was intubated and defibrillated, with the cardiac rhythm returning to normal. The first sample of urine, passed four hours after the cardiac