A 55-year-old woman with Parkinson's disease presented to the emergency department with out-of-hospital cardiac arrest at home. The paramedics arrived 7 minutes after the cardiac arrest, and cardiopulmonary resuscitation (CPR) was initiated. Initial rhythm was asystole. She was transported to the hospital by ambulance 29 minutes after the cardiac arrest and received a single dose of epinephrine in transit. After intubation, transesophageal echocardiography was performed while the chest compression point was at the internipple line (Figure 1 and Video E1, available online at http://www.annemergmed.com).
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