HCMC – Patients with dilated cardiomyopathy hospitalized with a risk of death of up to 90%. However, after providing first aid and applying many techniques, doctors successfully saved the patient’s life.
The patient is examined by a doctor before being discharged from the hospital. Photo: MY Hanh
Patient HVL (59 years old, Ben Tre province) has had dilated cardiomyopathy for the past 4 years but has not received stable treatment.
On March 24, the patient suddenly had difficulty breathing and went into cardiac arrest at the inn. The patient was quickly taken to the emergency room by his family. After cardiopulmonary resuscitation and continuous electrical cardioversion for 20 minutes because of ventricular arrhythmia, the patient regained natural circulation.
However, due to underlying cardiovascular disease, dilated myocardium with impaired contractile function of both ventricles and severe hypotension requiring high doses of vasopressors, acute pulmonary edema, predicting the risk of death. almost 90%. After inter-hospital consultation, the patient was transferred that night to Gia Dinh People’s Hospital.
Here, the ECMO team of the Cardiovascular Resuscitation Unit was ready, the patient received hybrid arteriovenous ECMO intervention within 30 minutes, central hypothermia and continuous dialysis support.
MSc.BS. Nguyen Thanh Thao – Head of the ECMO team – said: “We have to use vasoactive drugs along with inotropes and anti-arrhythmic drugs. The contractile function of the left ventricle and right ventricle was severely reduced (left ventricular ejection fraction only 15%), causing the patient’s progression of multiple organ failure after prolonged cardiac arrest to become more severe even with support. extracorporeal circulation.
According to MSc.BS. Tran Thi Ngoc My – Heart failure treatment specialist, Cardiovascular Resuscitation Unit: “For dilated cardiomyopathy, currently at specialized cardiovascular centers, we can completely predict the risk of sudden death.” due to ventricular arrhythmia based on clinical phenotype, combining cardiovascular imaging diagnostic methods and screening for dangerous gene mutations. Patients with dilated cardiomyopathy with a high risk of sudden death due to ventricular arrhythmia can be effectively prevented by optimal medical treatment of heart failure, with implantation of a defibrillator (ICD) when indicated.
After 1 week of persistent resuscitation using many specialized techniques, the patient’s health gradually stabilized, consciousness was completely restored, respiratory support measures and artificial circulation were stopped completely after 10 days and discharged from the hospital on the afternoon of April 15, 2024. This is the third consecutive case within the past month of sudden death due to out-of-hospital cardiac arrest, and is also the most serious case successfully saved at Gia Dinh People’s Hospital.