Through medical history, the patient's family said that Mr. T. suddenly had a severe headache, then rambling and difficult to hear, so he was transferred to the emergency room at a hospital in Ho Chi Minh City. Here, Mr. T. was diagnosed with a stroke and successfully underwent digital subtraction angiography to remove the blood clot. After the intervention, the patient was alert and able to eat and drink.
Thinking that the danger was over, suddenly Mr. T. had difficulty breathing and felt very restless. Based on the results of the paraclinical tests, the doctors diagnosed the patient with a hemorrhagic cerebral infarction, acute myocardial infarction, heart failure with reduced EF, on the basis of untreated hypertension, type 2 diabetes and dyslipidemia. After the doctors intubated the patient, he was transferred to Gia An 115 Hospital.
Prognosis is very grave with many risks
On April 17, specialist 2 Duong Duy Trang, Deputy Director of Gia An 115 Hospital, said that the patient had signs of cardiogenic shock, heart failure due to acute myocardial infarction, pneumonia, and a very serious prognosis. After receiving the patient, the doctors immediately gave the patient vasopressors, blood pressure medication, and antibiotics, closely monitored the patient's ventilator condition, then quickly performed the necessary clinical tests and consulted with the Cardiology department.
Doctor examines patient after intervention
Paraclinical results showed that the patient had acute myocardial infarction, 2-vessel coronary artery disease, 80% coronary artery stenosis... In addition, the patient also had kidney stones, increased liver enzymes and gastroesophageal reflux.
"With coronary artery stenosis, it is necessary to perform angiography, angioplasty and coronary artery stenting immediately. The difficulty is that the patient is in a coma, on endotracheal intubation, has unstable blood pressure, is in poor health and has just suffered a stroke. This is a big challenge for the intervention because of the high risk rate. However, if not intervened promptly, the patient's life will be threatened," Dr. Trang shared.
Decision to place stent for patient
After intensive resuscitation, the doctors decided to perform coronary angiography, angioplasty, and stent placement for the patient. After the vascular intervention, the doctors continued to intervene by placing a central venous catheter through the internal jugular vein to continuously monitor hemodynamics, and to infuse medication, fluids, and nutrients for the patient.
Along with continuing active medical treatment, doctors also closely monitored cardiovascular conditions, blood pressure, blood sugar control, etc. Thanks to that, the patient's condition improved positively and he recovered well. The patient was successfully removed from the endotracheal tube, his indicators gradually stabilized and he was discharged home.
Dr. Duong Duy Trang recommends that for patients with underlying diseases such as high blood pressure, high blood fat, diabetes, treatment and control of blood pressure, blood sugar, and blood fat is very important to prevent cardiovascular diseases as well as dangerous health complications. If there are risk factors, patients need to pay special attention to regular check-ups, screenings and a healthy lifestyle to prevent disease.
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