A 43-year-old man, who had a sudden heart attack, had gone to the hospital, and was unwilling to cooperate with the treatment, saying that he was fine. As a result, he repeatedly had ventricular fibrillation and defibrillation several times within 6 hours after admission to the hospital, and finally failed to be rescued and regrettably passed away.
People with acute myocardial infarction, if they can safely reach the hospital, it is not good to say, this is a kind of luck, or the favor of the Jade Emperor.
Because of sudden acute myocardial infarction, many people do not have the opportunity to go to the hospital, either in aggravated sudden death, or in the hospital halfway sudden death.
1 hour before the onset of acute myocardial infarction, the patient develops ventricular fibrillation (a type of cardiac arrest that requires electrical shock defibrillation). The risk is 25 times greater than that of 1 hour.
Therefore, if a patient with acute myocardial infarction can successfully reach the hospital, the possibility of being rescued has been greatly improved.
The 43-year-old young man, at 3 p.m., suddenly felt chest pain, accompanied by chest tightness and breath retention, and sweating profusely. Hurriedly drank a few sips of hot water, massaged the chest with his hands, and took a deep breath, but various operations failed to relieve the chest pain. The wife looked at him with a wet cold sweat and said let's call 120. The patient said no, what to spend that money on, it's okay, I just drive there.
The patient was very sharp, and eventually the wife drove the man to the hospital.
At the registration office, when looking at the patient's status, the patient was not registered, and the green channel of the chest pain center was immediately activated, and the medical staff was immediately found to help the patient to the rescue bed and pushed into the rescue room.
Immediately on ECG monitoring, blood pressure measurement, electrocardiogram, ECG prompt: acute inferior wall, posterior wall, right ventricular myocardial infarction.
While giving patients oral aspirin and ticagrelor, establishing a liquid channel, and giving 3000u heparin anticoagulation, we were notified of cardiology consultation.
After the cardiologist arrived, the patient was diagnosed with acute myocardial infarction, and it was recommended that the patient perform an angiogram to see which blood vessel was blocked and open the blood vessel immediately, so as to alleviate the symptoms, and most importantly reduce the risk of myocardial infarction and sudden death.
However, the patient refused to take a stance, saying that he would definitely have a stent after the contrast, and he did not want to put a stent at such a young age, and he would have to take medicine for a lifetime.
The doctor explains: Angiography is a test and does not necessarily require stents; of course, you are now acute myocardial infarction, and it is estimated that you must put a stent. Without a stent, the blood vessels cannot be opened, the heart will suddenly stop at any time, and even if the stent is not placed, you will have to take medicine for a lifetime.
His wife also advised him to listen to the doctor, but was glared at by the patient.
The patient was very sharp and refused to have an contrast test.
The doctor suggests that it be thrombolytic as soon as possible, and when asking the patient's family and signing the thrombolysis consent form, the patient must sign it himself. Lying on the bed by myself, looking at the consent form, I said: I'm fine, no pain, no thrombolysis, you just give me infusion and stay for a few days.
Theoretically, acute myocardial infarction, a very small number of people may have vascular recanalization, we immediately review the ELECTROCARDI, but the ECG shows that the patient's blood vessels are not self-passing. Therefore, it is still recommended that patients thrombolysis.
The wife said that we should use this medicine first, but the man still did not agree.
The patient was very sharp, and finally signed the two words of rejection on both the contrast notice and the thrombolysis notice.
The most formal treatment for acute myocardial infarction is to open the blood vessels as soon as possible, and the only way to open the blood vessels is to dissolve the blood vessels or stents. But this patient, refusing the stent, refusing thrombolysis.
Some people asked, afraid of stents, why are you still afraid of thrombolysis?
Thrombolytic therapy is simply infusion, but the fluid infusion is a thrombolytic drug, you want this drug to dissolve the blood vessels, dissolve; naturally there is a risk of bleeding, but the patient is not even willing to bear the most basic risk.
We have repeatedly explained that thrombolytic, non-stenting, the danger is greater, because the blood vessels are not opened, at any time there will be ventricular fibrillation, will sudden death; even if there is no ventricular fibrillation, there will be no sudden death, the myocardium is constantly necrotic, which will greatly increase the risk of heart failure in the future, and the life expectancy will be shortened after heart failure.
The patient is very sharp and chooses the so-called conservative treatment, that is, taking medicine, injections, and infusions.
The patient himself said that his symptoms were relieved, but the electrocardiogram showed that the patient's blood vessels were not connected, and 5 hours after conservative treatment in the intensive care unit, the patient suddenly lost consciousness, the monitor alarmed, and the patient had ventricular fibrillation. The doctor immediately shocked defibrillation, and after defibrillation, the patient's heartbeat returned to normal; but within 5 minutes, the patient had ventricular fibrillation again, and the electric shock defibrillation was again. At this time, the patient said, either you give me thrombolysis, do the stent.
Before further discussion, the patient had ventricular fibrillation again and continued to defibrillate, even though we had given treatments such as potassium supplementation and suppression of sympathetic storms in advance, but the patient had repeated ventricular fibrillation because the blood vessels were blocked and the blood vessels were not opened. After the last defibrillation, the patient's heartbeat did not recover and directly became, a linear electrocardiogram. Immediate chest compressions, cardiopulmonary resuscitation, endotracheal intubation, but it was too late.
Even in hospital intensive care units, even if there is no delay for a second, even if there is a defibrillator, even if a professional cardiovascular doctor is resuscitation, even if there is so-called adrenaline, dopamine and other rescue drugs.
But all this can only be said to improve the success rate of rescue, and does not mean that it is a gold medal to avoid death. Eventually the patient left, only 43 years old...
Outside the guardianship room, the tearing cries of the wife and daughter-in-law did not stop for a long time...
If he is not so sharp, even if such a serious acute myocardial infarction occurs, if he can listen to the doctor's advice, go to the contrast and do the stent, open the blood vessels; or do thrombolysis, assuming that the thrombolysis is successful, then the patient's chances of survival are very, very large.
We started to say that it was already a blessing to be able to go to the hospital, but this 43-year-old patient was too sharp! Throwing this kind of luck, hard to abandon, throwing far away, far away even he himself can not find it...
In the face of disease, especially in acute myocardial infarction, the sharp can not save life, the sharp can only kill!