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Dr. Pravin Kahale: Anterior Wall Myocardial Infarction in 55 year old

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Dr. Pravin Kahale: Anterior Wall Myocardial Infarction in 55 year old

A 55 years old male with no significant past history, complained of chest pain on 29-06-15 associated with sweating. He was taken to a private nursing home where he was diagnosed with Anterior wall Myocardial Infarction (Heart Attack) and was managed conservatively.  He was drowsy and had low Blood Pressure. Due to worsening condition he was advised a transfer to higher centre for further management.  While transferring to Kokilaben Ambani Hospital he had Cardiac Arrest in the ambulance for which cardio pulmonary resuscitation was given and was started in Inotropic support to bring up his blood pressure.  He was admitted in Kokilaben Hospital with cardiogenic shock status on 04-07-15.  In view of his drowsiness he was referred to Dr. Sachin Mishra (Neurology) who advised CT Brain that showed Mild stroke (ACA and MCA watershed infarcts).  After preliminary investigations a collective decision to proceed with Coronary Angiography was taken. The Angiography revealed significant block in main blood supplying vessel. 

Hence Emergency Coronary Angioplasty was done.  His vitals were supported with medicines (Inotropes) and IABP (External BP Machine). The damage to the heart due to the Heart attack had resulted in significant reduction in heart function to 20%.  In the ICU, he had sudden onset ventricular tachycardia (life threatening rhythm of the heart).  His rhythm was converted with shock treatment twice after which the heart reverted to normal rhythm.  Supportive medications to maintain normal heart rhythm were started. He was given support via mechanical ventilation.  His condition improved gradually.  Mechanical support and ventilation were taken off on 14-07-15.  In view of ventricular tachycardia episode he was advised AICD implantation which was done after stability. Single chamber pacemaker was implanted on 21-07-15. Patient was stable and was discharged on 25-07-15. On discharge he was advised to continue medicines and regular follow up for  dressing.  Currently he is doing well and leading a normal life.

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