On September 2, 2022, at 4:30 am, a troubled 65-year-old man sought solace at the Pangi center. Welcomed by compassionate healthcare professionals, they quickly recognized the urgency of his condition. Despite the intensity of his pain, he remained conscious and oriented; remarkably, he carried no prior medical or surgical history.
Acting swiftly, the attending physicians adhered to the guidance of the government doctor. They administered a loading dose of Tab NTG, additionally, an injection of Pantop 40mg was administered, aimed at mitigating the discomfort caused by the unsettling symptoms.
The blood pressure reading of 160/100 mmHg indicated the severity of the situation, while the pulse rate of 54 beats per minute reflected the burden borne by his weakened heart. With each breath measured, the respiratory rate stood at 24 breaths per minute, while oxygen saturation remained reassuringly high at 98% when breathing ambient air.
Understanding the pressing need for a comprehensive evaluation, an electrocardiogram (ECG) was conducted without delay. The highly sensitive Trop-I test yielded a negative result, indicating the absence of cardiac muscle damage. However, the ECG revealed an inferior lateral wall myocardial infarction (MI); simultaneously, the diagnosis of both myocardial infarction and pulmonary edema painted a complex picture, heightening the urgency of the situation.
The emergency physician connected with a specialist in Chennai. Through their collaboration, it was unanimously decided that thrombolysis, a procedure aimed at dissolving blood clots, was the best course of treatment.
With the patient’s consent and the guidance of the emergency physician, the government doctor administered Streptokinase 1.5 IU in 100 ml of normal saline over one hour. During this critical phase, the patient’s blood pressure was meticulously monitored every two minutes, ensuring the procedure’s effectiveness while remaining attentive to any potential complications.
As the minutes wore on, the patient, amidst the miraculous unfolding of his recovery, found himself grappling with pain. Understanding his suffering, the attending physician recommended an intravenous injection of Tramadol 100mg in 100 ml of normal saline, providing him with much-needed relief.
Following the completion of the thrombolysis, the patient’s vital signs were once again observed and documented. This time, the blood pressure showed a marked improvement at 110/80 mmHg. Similarly, the pulse rate, now at 64 beats per minute, suggested a more stable cardiac rhythm
With the passage of an hour, a repeat ECG was conducted, and the report was swiftly shared with the vigilant Apollo emergency doctor. The doctor acknowledged the patient’s stable condition and recognized the need for further specialized care. A recommendation was made to transfer the patient to a higher medical center, equipped to provide comprehensive management and continued healing.
The necessary arrangements were made, and the patient was promptly transported to the designated higher center, bolstered by the comforting presence of skilled medical professionals by his side.
A follow-up call on September 2nd revealed that the patient had been admitted to the hospital and was undergoing the vital treatment required for his recovery. Finally, on September 9th, the patient underwent a successful angioplasty, a procedure aimed at restoring the blood flow to his heart. On September 11th, 2022, the patient, now hemodynamically stable, was discharged from the hospital. As he stepped out into the world once more, a sense of gratitude engulfed him, prompting him to express his heartfelt appreciation for the timely diagnosis and prompt treatment that had saved his life.
