The bad news: Jay was in cardiogenic shock, a life-threatening condition in which the heart is suddenly unable to pump enough blood and oxygen to support the body’s vital organs. In cardiogenic shock, the heart muscle begins to lose its ability to contract, causing a vicious spiral of reduced cardiac output, low blood pressure, and weaker contractions. The shock was likely the result of a massive heart attack. In the past, patients in cardiogenic shock usually died; now, if treated immediately, about half survive 1. Risk factors for cardiogenic shock include older age, a history of heart attacks or heart failure, coronary artery disease that affects the heart’s major blood vessels, high blood pressure or diabetes.2
Jay had none of these risk factors.
Jay was rushed to the cardiac catheterization laboratory – or “cath lab.” There, physicians found two of the three main heart arteries were blocked. A blockage in the left artery has been dubbed “the widow-maker” because few patients survive it.
Mark Zolnick, MD, FACC, FSCAI, an interventional cardiologist at the New Mexico Heart Institute, performed an angioplasty and placed stents to reopen Jay’s arteries.
Would it be enough to save his life?
Jay’s family came, too, and they looked for ways to lift his spirits. A single dad, Jay adored his 4-year-old daughter, Emily. But she was too young to visit the Intensive Care Unit (ICU). So his family recorded Emily singing “Twinkle, Twinkle Little Star,” and kept it playing by his bedside as he lay unconscious.“
“He had a strong support group from his military colleagues and his family,” Dr. Vellinga said. “They were there the whole weekend.”
Meanwhile, the Impella 2.5 was doing its job and allowing Jay’s heart to rest. “He just kept getting better and better,” Dr. Vellinga said.
By Sunday, Dr. Vellinga was confident that Jay was on his way to recovery. After several days, the Impella 2.5 was removed, and Jay’s heart was strong enough to function without mechanical support.
But a massive heart attack can inflict significant damage on both the heart and, potentially, on the brain, given that both were deprived of oxygen.
- Mayo Clinic definition: http://www.mayoclinic.org/diseases-conditions/cardiogenic-shock/basics/definition/con-20034247
- NHLBI http://www.nhlbi.nih.gov/health/health-topics/topics/shock/atrisk
- CHI Health. http://www.chihealth.com/lvad-vad-impella
- SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Cardiac Assist Devices in Cardiovascular Care. http://www.scai.org/Press/detail.aspx?cid=91078003-f938-4133-854d-fdb1febcd1b8#.VSWfHnl0zX4
Impella® Protects the Heart During Cardiogenic Shock
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