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An Unusual Indication for Precordial Thump: Acute Prosthetic Valve Obstruction

Published:January 06, 2023DOI:https://doi.org/10.1053/j.jvca.2023.01.001
      THE DELIVERY of a closed-fisted blow to the sternum has been described for more than 100 years as a resuscitative technique. In 1920, Schott reported the use of repetitive sternal blows (known as fist or percussion pacing) in the setting of asystole.
      • Pellis T
      • Kohl P.
      Extracorporeal cardiac manual stimulation: Precordial thump and precordial percussion.
      Subsequent reports emerged in which a single precordial thump (PT) delivered to the middle or lower sternum was occasionally effective in terminating a ventricular tachyarrhythmia.
      • Koster RW.
      Precordial thump: Friend or enemy?.
      Current life support guidelines continue to include PT, albeit accompanied by a weak recommendation and in the limited setting of a witnessed and monitored ventricular tachyarrhythmia when a defibrillator is not immediately ready for use.
      • Panchal AR
      • Bartos JA
      • Cabanas JG
      • et al.
      Part 3: Adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.

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