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Case Records of the Massachusetts General Hospital
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Volume 350:2281-2290 May 27, 2004 Number 22
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Case 17-2004 — A 42-Year-Old Woman with Cardiac Arrest Several Weeks after an Ankle Fracture
Samuel Z. Goldhaber, M.D., Eric S. Nadel, M.D., Mary Etta King, M.D., and Amita Sharma, M.D.

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Presentation of Case

Dr. Vicki E. Noble (Emergency Medicine): A 42-year-old woman was admitted to the emergency department of this hospital after cardiac arrest with pulseless electrical activity.

Approximately two weeks before admission, she had fractured her ankle when slipping on the ice. A closed reduction was performed, and a short leg cast was applied. According to her husband, on the evening of admission, the woman stood up from the couch, said she had chest pain and shortness of breath, and collapsed, apparently unconscious, with synchronous jerking of her arms and legs. Her husband called emergency medical services; the paramedics found the woman . . . [Full Text of this Article]

Differential Diagnosis

Discussion of Management

Risk Stratification

Thrombolysis

Embolectomy

Optimal Duration and Intensity of Anticoagulation

Final Diagnosis


Source Information

From the Cardiovascular Division, Department of Medicine (S.Z.G.), and the Department of Emergency Medicine (E.S.N.), Brigham and Women's Hospital; the Departments of Emergency Medicine (E.S.N.), Pediatric Cardiology (M.E.K.), and Radiology (A.S.), Massachusetts General Hospital; and the Departments of Medicine (S.Z.G., E.S.N.), Pediatrics (M.E.K.), and Radiology (A.S.), Harvard Medical School — all in Boston.


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