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Prompt surgery is life saver: proves Fortis

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Heart attack can be life threatening if not diagnosed in-time.  A heart attack happens when heart muscle is starved of oxygen-rich blood which tends to cause damage to one’s heart muscle. In some cases, heart attack causes multiple blockages and hole in the heart (Ventricular Septal Rupture) which is a rare occurrence.

The 62 year old patient-Basavappa’s (name changed) life was saved by Doctors at Fortis with timely emergency procedure done on him proves to be a life-saver.  He was suffering from multiple blockages and a gaping hole in the heart caused by heart attack.

As most of the heart attacks are treated with Angioplasty alone, but care should be taken to check with other symptoms. In Basavappa’s case a coronary artery bypass grafting (CABS) was done to remove blockage in blood vessels leading to heart. An ECMO (modified heart- lung machine that pumps and oxygenates the patients’ blood) support was followed after the heart surgery which allowed heart and lung to rest and helped in fast recovery of the elderly man.

Patient and his suffering

download-3 When 62-year-old Basavappa started walking with a hunch, his son and wife knew that something was not right. The elderly man would sweat profusely and developed breathing difficulties but when his family members expressed trepidation about his health, he brushed it aside.

For two days, Basavappa suffered the discomfort and complained about rising chest pain, his family took him nearest clinic in their locality.  After a check up, doctors at the clinic revealed that the elderly man had suffered a severe heart attack and needed immediate medical attention.

After referring to Fortis Hospital, Basavappa was diagnosed with a huge hole in the heart (Ventricular Septal Rupture) caused by the attack including multiple blocks in the blood vessels.  Swift attention by the team of doctors ensured his timely treatments which lead to process emergency procedure of removing blocks and repairing the hole. Team of Fortis Doctors managed to save his life with the help of their prompt and intelligent act.

The Diagnosis

When 62-year- old Basavappa came to Fortis Hospitals with complaints of breathlessness and chest pain, doctors knew that they had to act swiftly.

“As soon as the patient was brought in to the emergency ward, we did an immediate check up and ran tests including ECG, ECHO and coronary angiography. Majority of heart attacks are treated urgently by angioplasty procedure but in some patients it is very important to check for other serious cardiac problems. In this patient, the tests revealed that not only did the patient have multiple vessels blockage but he had suffered what is called Ventricular Septal Rupture after the heart attack, which is a serious cardiac illness and can be fatal if not treated with a timely emergency procedure,” said Dr. S Venkatesh, Consultant Cardiologist at Fortis.

Ventricular Septal Rupture is a rare but lethal complication of Acute Myocardial infarction (AMI) commonly known as heart attack and usually occurs about two to eight days after the attack. AMI is a life threatening condition where the muscles of the heart die due to decreased blood supply, when the coronary arteries become blocked. Timely medical help in AMI is very important in the initial few hours as the right treatment can salvage the muscles and help preserve function of the heart.

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When heart attack is not treated on time, it can lead to Ventricular Septal Rupture:

  • Wherein the dead muscles leads to a rupture or hole in the wall between the left and right ventricles.
  • Patients developing such complications have symptoms :
  1. Breathlessness,
  2. low blood pressure and
  3. Multiple organ failure.

Survival rates in these cases are about 50 per cent and it all depends on timely detection and therapy given by the doctors.

“A hole in the heart in adults as a result of heart attack is much more complex than congenital Ventricular Septal Defect, which is a hole in the heart present at birth. In children, the hole sometimes closes by itself or can be closed with a simple surgery but in adults the surgery to repair the hole is much more complicated and requires a lot of precision,” said Dr Vivek Jawali, Chairman, Department of Cardiovascular Science at Fortis Hospital.

With alertness, clockwork precision and superb teamwork between various departments including emergency medicine, radiology and cardiac surgery, Fortis doctors were able to assist the patient. The cardiac team started the surgery on the patient within 35 minutes after he was admitted to the hospital.

In a highly specialised procedure that lasted for more than 8 hours, Dr. Vivek Jawali and his team conducted Ventricular Septal Repair, wherein the huge hole measuring 3 cm was closed and patched up using synthetic material. A coronary artery bypass grafting (CABG) was done to remove the blocks in the blood vessel leading to the heart. This type of surgery improves blood flow to the heart, by building up
of plaque inside the coronary arteries preventingoxygen-rich blood supply to the heart.

“The patient was put on ECMO support after the surgery. ECMO is a modified heart-lung machine that download-2pumps and oxygenates a patient’s blood, thus allowing the heart and lungs to rest. After four days he was taken off the ECMO and he has been doing really well since then,” added Dr. Murali Chakravarthy, Director, Department of Ansthesia, Fortis Hospitals, Bannerghatta Road.

It is important to note that lot of heart attacks are usually treated with angioplasty alone, but proper check up of other symptoms is also necessary. Interestingly, preparedness and quick decision making of doctors can bring change and save someone’s life.

“All over the world, survival of elderly patients with this condition even after a well done operation is not good. The trick of an improved chance of survival is to convince the family, cut the red tape and operate at the earliest, before the heart muscle stretch and deteriorate due to the sudden volume overload.” added Dr. Vivek Jawali, Chairman, Department of Cardiovascular Science at Fortis Hospital.

This patient’s survival is an example of a harmonious team work and quick decision making.

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