How many strangers do we meet on a day-to-day basis? Sometimes, they are helpful and at other times they may be extremely helpful. Such was the case of 50-year-old Markondappa, whose life was saved simply because of the timely intervention of a total stranger.
Markondappa was driving back home when he had a road traffic accident. “While I was taking a U-turn, I suddenly banged the pole near Forum Mall, Whitefield. I am suffering from cardiac problems for past 10 years. However, this is the first time when I fell unconscious. I could not remember anything until doctors at Columbia Asia Hospital treated me,” said Markondappa.
An onlooker took charge of the situation and without wasting a minute, he made up his mind to drive straight to the emergency department ofColumbia Asia Hospital, Whitefield. “Mr. Markondappa was brought to the hospital unconscious, with no recordable pulse or blood pressure. He was in a state of cardiac arrest,” said Dr.Pradeep ,Consultant in EmergencyMedicine who immediately began cardiopulmonary resuscitation and called a Code Blue( an emergency hospital response for patients who are in cardiac arrest) which brought the Cardiology and ICU teams to the Emergency Room within a matter of seconds.
“Patient had sustained damage to chest wall causing hemopneumothorax, a condition where air and blood gets collected around the lungs compressing both lungs. This was diagnosed with an ultrasound during ongoing CPR. The patient immediately had bilateral chest tube insertions. After 30 minutes of CPR, patient had return of pulse. Unfortunately, he had an abnormal heart rhythm for which a temporary pacemaker was emergently placed in the ER.” The resuscitation team comprised of Dr.Pradeep N, Consultant in Emergency Medicine, Dr. Ashok E and Dr.Ramkumar J , Consultants in Intensive Care Medicine and Dr. Naveen Chandra G.S, Consultant in Interventional Cardiology who all stated that he was fortunate to have been brought immediately in the Golden Hour.
As there was no information available on when the patient had lost consciousness, he was kept in ICU on ventilator and blood pressure support. In the next 24 hours, the patient recovered with no neurological damage. Later, on evaluation, it was clear that he had lost consciousness because of cardiac rhythm abnormality which led to the accident, causing those injuries. He underwent permanent pacemaker implantation along with cardiac resynchronisation therapy which will help in improving cardiac functions on the long run. Patient was discharged after two weeks’ post-admission, with no neurological sequel.
“Cardiac patients, especially with baseline rhythm abnormality and poor cardiac functions are at higher risk of sudden cardiac deaths. They are prone to heart blocks and arrhythmias causing cardiac arrest. This can be very dangerous specifically for professionals like drivers, pilots, sports men,”said Dr. Naveen Chandra G.S, Consultant – Interventional Cardiology, Columbia Asia Hospital, Whitefield, who along with team of cardiologists consisting of Dr.Naga Srinivas and Dr.Satish were involved in cardiac care of the patient.
“This particular case signifies the importance of risk stratification and identifying certain subgroup of patients where timely intervention and treatment modality can change the outcome. The prediction and avoidance of such mishaps have been a constant challenge,” added Dr. Naveen Chandra G S.
It is not uncommon to see cases of cardiac complications in the emergency room of a hospital. However, what makes this case unique is the fact that he was brought to the hospital as a Road Traffic Accident (RTA) case, but had actually suffered a cardiac complication with led to him to fall unconscious while driving. The doctors at Columbia Asia Hospital, Whitefieldimmediately identified his condition and prioritized management care before the patient’s condition could be terminal.
Many cardiac patients do not have knowledge of warning signs and symptoms which could potentially be life threatening. The awareness and knowledge of warning symptoms and timely interventions in such high-risk patients can help them to minimize such mishaps. Some of the symptoms as pointed by Dr. Naveen Chandra include:
- Chest discomfort
- Shortness of breath
- Nausea or lightheadedness
- Recurrent blackouts and loss of conciseness
- feeling of missed beats