The last week was a very rewarding week medically to all of us at the hospital! At around 11 PM in the night we had a patient who came with severe chest pain since the past 1 hour or so.
The pleasant Kenyan man also happens to be our friend. At 54 years and well-controlled Diabetes there were not much risk factors for a heart attack. Nevertheless an ECG revealed a massive heart attack in the base of his heart (we also suspected the same especially because of a low heart rate, low blood pressure and intense sweating). Having diagnosed an imminently life-threatening heart attack the next steps were crucial. Immediately we set up the defibrillator in lieu of thrombolyzing the clot in a major artery that was causing the heart attack in this patient. The defibrillator is a must because as soon as patency of the artery is restored with the special medicine I will talk about there is every chance of a massive disturbance in the heart’s rhythm which could possibly kill the patient! Next we loaded up TENECTEPLASE – The clot buster, and injected this into a large peripheral vein over 10 seconds. Within minutes the patient’s heart rate did the predictable ‘dance’ but luckily we did not have to defibrillate him. All the usual medications (Aspirin, Nitrate, Morphine, Oxygen etc) were started.
After an hour or so the ECG was almost normal but as his heart rate was still hovering around the 40-50 range we considered the possibility that he might need pacing and thus we shifted him to Mombasa Hospital. However he stabilized and did not have the need for pacing and the patient was continued on our previous management protocol.
As I am typing this out the patient came back to recuperate in Diani Beach Hospital on the 28th July 2013 and looks absolutely great!
Yep! Yet another mini achievement for Diani Beach Hospital!!
