While preparing for the Bangalore Half Marathon, Mr. Shashi Pratap, 35, suffers a heart attack, battling for breath for 8 minutes.

ep-01-s1-insider-marathon-prep-turns-critical

EP 01 - S1 - InsidER - Marathon prep turns critical

On practice for the Bengaluru Half Marathon, 35-year-old Shashi Pratap suddenly suffered a heart attack. With the pulse gone for 8 minutes, will the doctors be able to save him? I am a part of a running club and I am a marathon runner. My coach gave me a plan of 25 kilometres. Till 4.5 kilometres it was going pretty well and then suddenly I collapsed. His doctor friend realised it was a heart attack and he administered CPR. Shashi Pratap was rushed to a hospital nearby. Security! It was the 9th of April. It was around 8 o’clock in the morning
and I got a call from Shashi Pratap’s friend and he told me that something had happened and he had collapsed and Shashi Pratap is hospitalised. The ER team was challenged to restart
Shashi Pratap’s heartbeat and to revive it. Doctors used a Defibrillator delivering shocks. On the second attempt, Shashi Pratap’s heartbeat came alive. After delivering DC shock the patient recovers
and his heart rate becomes normal and after intubating the patient we initiate him on a ventilator and we shift this patient to our ICU. The most important message in this case is that cardiopulmonary resuscitation or CPR. Soon after the patient collapsed the doctors over there did his CPR. CPR involves physically compressing the chest to facilitate blood flow from the heart to the brain. It's imperative in such cases. There's brain ischemic time. Meaning, that if the blood supply to the brain stops usually, 
the patient becomes brain-dead within three to five minutes. If we commence the CPR within this time
we may have the chance to save the brain. This is very important for the patient's recovery. When I reached the hospital, the doctors were
waiting for me and he told me three things. He said that your husband had a cardiac arrest,
he is on a ventilator and his brain is not functioning. They told us that we can go back home and rest for a bit
and come back in the morning because I was expecting at that time, I was four months pregnant. We went back home, got her breakfast
and then everybody was sent home again. That was the moment we were thinking about what to do next. So we spoke to the doctor and then he suggested that it’s better to shift him to the main Narayana Hospital. I organised the transfer from Narayana Health, HSR to our hospital by discussing with the emergency team. We received him at 6 PM in our emergency room. We continued to resuscitate him, we continued his ventilatory support. We continued to support his heart
with inotropic support. We checked his airways, we saw his ventilator status we put him on a ventilator,
started him on ventilatory support. Later on, we did his vitals check for if he is requiring higher support
for BP improvement or anything as such. We were worried about his neurological status as well. We did counselling of the patient's relatives. We told them what had
happened to the patient and explained to them in detail
the course of the treatment. We will take him now for an angiogram procedure and after that
we will first be doing an angiogram to identify where the block is. This patient had a 70 to 80 per cent blockage in the
left anterior descending artery in the first part. We showed it to the family and told them that was why the patient collapsed. We have identified a block and now will need to treat
the block that is a procedure called angioplasty. So we will pass a guide wire through that block,
we will inflate that area with a balloon and put a stent there. They said that we need to put a stent so if we want to go ahead with that procedure we can do it right away. A guide wire with a balloon on the tip of the
catheter was inserted into the coronary artery. The blockage was removed by inflating the balloon
and placing a stent to keep the artery open, resulting in normal blood flow in the heart. So I think within 15 minutes, a stent was placed, angioplasty was done. Dr. Bagirath did it for him. They told us that the stent had been placed,
there is no reaction and his body is taking it well. After the angioplasty he was shifted to the coronary care unit. We kept him on a ventilator. We continued his support of his heart after angioplasty
but he continued to be unconscious. Even after angioplasty, Shashi Pratap’s condition remained critical constantly monitored by doctors in the ICU. The next day morning, when we were looking for neurological recovery, How is Mr. Shashi Pratap doing? He is doing good and he started moving his limbs. Oh, that’s good. Let me quickly examine him again. Mr. Shashi Pratap! If you can hear me, can you open your eyes? I know you opened your eyes. Can you also hold my fingers? Can you do that? That’s good!
Mr. Shashi Pratap! Can you keep your eyes open? Keep your eyes open Mr. Shashi Pratap.
Good! Can you lift your hands for me? Can you lift your hands up? Please raise it up. Some more. It’s good. Some more. Very good. Put it down. Okay, he is showing very good progress. After this, we discussed with the intensivist
we brought the patient out of the ventilator. It was like very happy news for us and then within 5-10 minutes I got a call from the nurse staff that he had regained
consciousness and he is asking for his wife. So it was like a really happy moment. Shashi! Swati was Shashi Pratap’s strength in these weak moments. Hello Shashi Pratap! How are you now?
I am good Doctor. Better? Take a deep breath. Excellent! He continued to work with the physiotherapist and
respiratory therapist and the speech and swallow therapist. So that those things could improve. Okay? Come. Born again. You don’t know when such things will hit you. You keep hearing things
around you like a person 35 years of age or 40 years of age got a cardiac arrest or heart attack and you feel like such things will not happen
to you but you just can’t perceive, you just can’t imagine how it’s gonna be until
it happened to you or your family member but the good thing is that he is back and his love of running is too much and he is already back to running and he is now monitoring all his stats. It’s working well and we recently became parents and we had a little baby girl and she is just 18 days old right now. So it’s all good and it’s all well now. I have a question.  Would you like to save someone’s life?  If you do, I’ll request you to learn 
CPR- Cardiopulmonary Resuscitation (CPR). It will take you just a couple of hours to learn 
the art of saving someone’s life.  In the process, if you’re shopping in the shopping mall,  you see somebody collapsing all of a sudden– believe me,  you will have the knowledge, how to resuscitate a dying person.  Believe me, this is a skill which can save few lakh lives every year.  Please learn CPR and you will have the privilege of becoming a life saviour. A child who has been on a ventilator for the past 20 days. Will his mother's unwavering faith  and capable doctors be able to save him? 

Dr.

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