Incidence andSignificance of Upper Body Cyanosis in Nontraumatic Cardiac Arrest

Abstract

Objective. Upper body cyanosis is a physical finding sometimes noted at the time of cardiac resuscitation. We attempted to determine the incidence andsignificance of upper body cyanosis in cases of nontraumatic cardiac arrest. Methods. This was a retrospective case-control study. We reviewed all nontraumatic cardiac arrests evaluated by King County, Washington emergency medical system (EMS) personnel during 2000–2004 andidentified patients with upper body or nipple-line cyanosis. Those patients who were autopsied comprised the cases for our study. Cases were age andsex matched with controls who also had cardiac arrest with an autopsy but no mention of cyanosis. Results. EMS personnel treated 3,526 patients, age 18 andolder, for nontraumatic out-of-hospital cardiac arrest. One hundred eight (3.1%) had specific mention of upper chest or nipple-line cyanosis, of whom 38 had autopsy. Among the 38 autopsy cases, 6 were died of hemopericardium compared to none in age-and sex-matched controls. Conclusion. Cardiac arrest with upper chest or nipple-line cyanosis had a higher incidence of hemopericardium or dissecting thoracic aortic aneurysm than patients without mention of cyanosis.

Key words:

• heart arrest
• cyanosis
• emergency medical services
• emergency medical technicians
• cardiac tamponade