Rohit Shishodia
Doctors at Wockhardt Hospitals, Mumbai, managed to save a 70-year-old businessman whose heart stopped beating for 10 minutes following a massive heart attack.

The patient, who had a complete heart blockage with blood pressure of 60 systolic, was revived by the doctors by successfully performing a high-risk coronary artery bypass surgery on him. The patient, Dilip Shah, collapsed on the road after having chest pain. He suffered from cardiac arrest in the hospital.

The patient was given Cardio-Pulmonary Resuscitation and cardiac massage for 10 minutes to revive him. A challenging coronary artery bypass surgery was performed that saved his life.

Shah, a resident of Bhyander area of the city, felt acutely unwell while walking on the road. He developed onset of acute chest pain and suddenly collapsed on the street on December 11, 2019. He was immediately rushed to the emergency department of Wockhardt Hospital.

On evaluation, it was revealed that he had complete heart block and low blood pressure. ECG suggested that he had suffered from myocardial infarction, also known as a heart attack. He was diagnosed with acute myocardial infarction with cardiogenic shock with a complete heart block.

Dr. Chetan Bhambure, Consultant Cardiologist, Wockhardt Hospital, informed, “The patient received emergency resuscitation and was subjected to angiography. A temporary pacemaker was inserted to stabilize his heart rhythm. His angiography revealed a 95% block in his left main coronary artery, 100% occluded right coronary artery and multiple blockages in the branches of the circumflex and left anterior descending artery.”

Dr Bhambure further added that he was not a suitable candidate for coronary interventional procedures (angioplasty) due to the extensive nature of the disease. His heart function had decreased significantly due to the massive nature of the heart attack, he said.

Dr. Bipin Jibhkate, Consultant Intensivist, said, “After angiography, the patient was shifted to ICU where he suffered from ventricular fibrillation and cardiac arrest."

Dr Jibhkate pointed out that the patient needed multiple cardioversions (a procedure to restore a regular heart rhythm), external cardiac massage (a rhythmic compression of the chest, using the hands to force blood through the blood vessels) and CPR. His heart regained the rhythm and blood pressure after 10 minutes of CPR.

The patient was stabilized in ICU with the help of inotropes, mechanical ventilation, antiarrhythmic drugs and intraaortic balloon pump support to improve his heart function.

He stabilised a bit in 48 hours and was taken up for coronary artery bypass surgery to improve the blood supply to his heart.

Dr. Upendra Bhalerao, Cardiac Surgeon, said, “A coronary artery bypass surgery was performed on Mr. Shah after medically optimizing his condition. He received bypass grafts to his four critically blocked coronary vessels (CABGx 4).”

Dr Bhalerao further added that the procedure was extremely high risk due to the critical nature of the blockages and poor heart function. Coronary artery bypass surgery is feasible even in unstable and critical patients done at centers with expertise.

“He tolerated the procedure well but remained critical and on intraaortic balloon pump support for the first 48 hours. Subsequently, he improved and was weaned off the ventilator, IABP, and Ionotropes. After complete recovery in two weeks, he was discharged. The patient has resumed his daily life without any cardiac symptoms,” explained Dr Bhalerao.