Acute myocardial infarction, commonly known as a heart attack, is a serious condition that needs emergency medical treatment. Heart attacks, when left untreated or delayed timely treatment, can result in worsening clinical status of patients, leading to low blood pressure, heart failure, irregular heartbeats (arrhythmias), cardiogenic shock and in extreme cases, sudden cardiac arrest.
When a patient with a heart attack develops sudden cardiac arrest in the hospital setting, immediate resuscitative measures using cardiopulmonary resuscitation (CPR) are carried out. But, despite the best of conventional CPR, patients with sudden cardiac arrest have a poor prognosis with < 10-15% chances of survival to discharge. Extracorporeal membrane oxygenator (ECMO)-assisted CPR, aka ECPR, is a lifesaver in this group of sick patients. Timely initiation of ECPR increases the chances of survival to discharge to > 30% in these patients. We, at Kauvery Hospital, Alwarpet, had the privilege of saving one such patient who presented to us in a very critical condition.
Mr. C, a 63-year-old gentleman, presented with intermittent chest pain of 1 week duration with an increase in intensity for 1 day. The patient was initially evaluated outside the hospital, diagnosed as acute anterior wall myocardial infarction with very low ejection fraction (20%) and referred in a sick state to Kauvery Hospital for further management. In view of the critical condition, emergency angioplasty was planned for the patient. As he was being shifted to the cath lab, he went into cardiorespiratory arrest. CPR was immediately initiated, but the patient did not have a return of spontaneous circulation despite 15 minutes of conventional CPR. Hence, ECMO-CPR was initiated via the right femoral vein and artery route, venous blood was circulated through a membrane (oxygenator) which cleared carbon dioxide from and added oxygen to the blood, which was circulated back into the body. This external circuit (ECMO) of circulation and oxygenation gave rest to the heart and lungs. Then, we were able to perform high-risk multivessel angioplasty for the patient. This improved his cardiac contractility over a couple of days. Later, ECMO was weaned off and patient was started on intra-aortic balloon pump (IABP) support.
During the CCU stay, the patient developed recurrent VT (ventricular tachycardia) storm, a life-threatening arrhythmia, which needed multiple interventions including anti-arrhythmic medications, sedation and reintubation, left stellate ganglion blockade (a local anaesthetic injection given in the neck to block the nerves to the heart) and radiofrequency ablation (current therapy to destroy the heart tissue that produces abnormal fast beats). Finally, after a stormy course of over 3 weeks, the patient stabilized and recovered with an ejection fraction of over 50% and was discharged home. This recovery would not have been possible without the timely initiation of ECPR and subsequent interventions, including multivessel angioplasty and radiofrequency ablation.
Dr Srikumar
Senior Consultant Interventional Cardiologist,
Kauvery Hospital, Chennai
Brought Back to Life: A Journey of Survival at Kauvery Hospital
I am Chezhiyan from Chennai. On 16th May 2025 early morning I was having severe chest pain. Immediately we visited our family physician, where ECG was showing abnormal. Doctor suggested for immediate procedure. So, we visit a hospital in Alwarpet and unfortunately No doctor was available to do the procedure. Since we had only very less time in our hand, we decided to go to Kauvery hospital Alwarpet and admitted in Emergency. Our family physician referred to Dr. Srikumar in Kauvery hospital. Dr. Srikumar was very calm and composed. He clearly explained my situation to my family members and suggested to go for Angiogram. Suddenly, I was having multiple cardiac arrest, without wasting time, Dr. Srikumar put me in ECMO, made me stable and performed a very risky angioplasty procedure. After which I was completely with ECMO and Ventilator support. With a regular follow up 24/7 care by Kauvery hospital doctor and Nurse, I was slowly regaining my conscious. However, still I was having unstable heart rhythm which was very uncommon. With Dr. Anantharaman experience and Dr. Deep Chand Raja guidance, they were able to identify the root cause for my unstable heart rhythm and with another tricky procedure, they arrested the issue and made me little stable. After which, I was slowly coming out of ECMO and ventilator. Almost 13 days I was completely under CCU and monitored. Then shifted to general ward and stayed for one week.
Today, I can get up by myself and able to walk by own. All because of timely decisions by doctors and continuous monitoring by the staff. I must say every security personnel in Kauvery hospital prayed for my health and all their prayers are answered by God.
