Spectacularly saving the life of an 83-year-old patient with cardiogenic shock and cerebral infarction

April 26, 2022 14:46 GMT+7

Patient Dinh TU (83 years old, Ha Long city, Quang Ninh province) has a history of hypertension, sequelae of cerebrovascular accident, incomplete paralysis of the right half of the body. The patient was transferred to Bai Chay Hospital for emergency after falling, stunned in a state of unresponsive calling, cold and moist skin, rapid heart rate, and low blood pressure. Doctors performed resuscitation, endotracheal intubation, and emergency electrocardiogram at the bed.

When the typical signs of myocardial infarction were detected on the electrocardiogram, the emergency physician team urgently consulted with a cardiologist, diagnosing cardiogenic shock due to low myocardial infarction on the background of infarct sequelae. brain, not excluding cerebral hemorrhage after shock, high mortality prognosis.

After excluding cerebral hemorrhage, the emergency physician team quickly coordinated with the specialists of cardiology, anesthesiology, and active resuscitation to perform cardiovascular intervention to save the patient’s life.

Through the digital imaging system erasing the background DSA detected that the right coronary artery was completely blocked due to thrombus.

Ths. Doctor Dinh Danh Trinh – Cardiology Department, Bai Chay Hospital and the coronary intervention team performed recanalization and placed a drug-coated stent in the blocked artery.

The patient was saved on a complicated pathology.

After the intervention, the patient received intensive resuscitation treatment with modern and intensive methods such as artificial ventilation, continuous dialysis combined with the use of cardiac drugs, vasopressors, etc.

CKI Doctor Nguyen The Hung – Head of HSTC Department, Bai Chay Hospital said: “The mortality rate in patients with cardiogenic shock due to myocardial infarction who are successfully saved in the US is up to 50%. In Vietnam the rate is much higher.

In this patient with a complicated and severe condition – myocardial infarction, cardiogenic shock accompanied by a background of cerebral infarction, after successful intervention, the resuscitation process requires doctors to monitor Closely monitor and control hemodynamics, avoid the risk of metabolic acidosis, multi-organ failure.

Up to this point, after 5 days of treatment, the patient has been extubated, the vital index is stable, no need to use the final solution of high technology – ECMO artificial cardiopulmonary.

According to Doctor Dinh Danh Trinh – Cardiology Department, Bai Chay Hospital, acute myocardial infarction is a condition in which the heart muscle is deprived of blood supply and necrosis due to the sudden blockage of a coronary artery (blood vessel supplying the heart muscle) by a blood clot. intravascular thrombosis…

The disease is common in middle-aged and elderly patients with comorbidities such as hypertension, diabetes, dyslipidemia, lack of physical activity, etc.

If not promptly intervened, it will cause dangerous complications such as arrhythmia, acute heart failure, stroke due to embolism, broken heart, sudden death… leading to death.

Death of myocardial infarction occurs at the highest rate within the first hour. Therefore, the race against time is a vital factor that determines the patient’s life.

K/Chi