Is it possible to perform an interventionist heart procedure on a 96-year-old who has had an acute heart attack? That was the question racing in Dr Bhusan Bari’s mind. The consultant cardiologist at Manipal Hospital, Pune, was not too sure about an emergency angioplasty that was the only shot at saving the woman’s life. And in the end, it did.
“She was 96 and her heartbeat was alarmingly low. Her diabetes and high blood pressure were under control though. Such cases are rare in geriatric patients and we had to explain the procedure to the relatives and the risks attached to it. There could be an injury to the kidney or post-procedure complications,” Dr Bari said. But the patient’s general practitioner seemed very confident about the general fitness of the woman, who till the episode, had walked daily and had sharp intellectual abilities. Her 67-year-old son gave his consent after which the doctor and his team saved her life with the help of a temporary pacemaker and emergency angioplasty.
“The doctor did an angiogram that showed a cent per cent block. We decided to go ahead with the procedure as I knew my mother was physically very active and her blood pressure levels and diabetes were under control. Post angioplasty, the doctor showed us on the computer screen how the artery had opened up and the blood was flowing,” said the much-relieved son. His mother responded well to the treatment and was discharged four days after admission.
Dr Bari recalled when the patient was brought to the hospital, she had complained of severe pain in the back and heaviness in the chest. Upon further evaluation and ECG, it was found that she had already suffered an acute heart attack as well as a heart block that led to an alarmingly low heart rate.
Heart attack is a fatal condition in which the blood supply to the heart is suddenly blocked due to clotting. This condition is very common after the age of 50 years. In this case, it was complicated by a complete heart block, Dr Bari said. A temporary pacemaker insertion was done to return heartbeats to the normal pace.
Then an angioplasty was done, as part of which a wire is inserted through the groin all the way to the heart to clear the clots. This treatment is extremely safe even for elderly patients as it requires a very small incision. Therefore, there are very few chances of infection or other complications during the procedure, and the patient can recover very quickly. This case showed that it can even work in geriatric cases.