Dubai: Timely diagnosis and emergency procedures saved the life of an expatriate patient who suffered from a heart aneurysm and several other health complications that necessitated three surgeries in quick succession.
Following a full recovery, the Indian man was discharged from the hospital within a fortnight after the surgeries and was able to fly to India to attend his daughter’s wedding on April 10.
In a haemorrhagic shock
Recounting the case, Dr P. Senthilnathan TT, specialist Cardiovascular and Endovascular surgeon at Aster Hospital Mankhool, said: “The patient, P Shajikuttan, reported to the Emergency Department of Aster Hospital Mankhool on March 23 in a semi-conscious state. He had been suffering from fever and fatigue for a few days prior to the hospital visit. He was rushed to the hospital after his colleagues found him vomiting blood and collapsing.”
Leaking heart aneurysm
By the time Shajikuttan reached hospital, he had lost a lot of blood. He was in a haemorrhagic shock. An immediate chest X-ray indicated that he had an aneurysm in his heart, in the thoracic aorta. A CT scan further revealed that the aneurysm was infected and was leaking. Any delay in attending to it could have caused a rupture and could have been fatal, the medical team attending to the patient said.
The team performed a minimally invasive Thoracic Endo Vascular Aortic Aneurysm Repair (TEVAR) procedure just in time. However, barely was he stabilised did the doctors discover several new complications involving multiple organs that needed immediate surgery. The leakage from the infectious aneurysm had filled up around the heart and the patient soon experienced a cardiac tamponade caused by pericardial effusion, Dr Naveed Ahmed, consultant Interventional Cardiologist attending to the patient, said. “We moved him from the cardiac ICU [Intensive Care Unit] to the catheter lab, where he underwent pericardiocentesis. The procedure drains fluid build-up around the heart. To our surprise, more than 300ml of pus was drained,” Dr Ahmed added.
Further complications
However, the next day, there were more health complications as doctors found blood in his oesophagus. Dr Amal Premchandra Upadhyay, consultant Gastroenterologist at the hospital, said: “Detailed investigation revealed that there was a tear on the oesophagus, caused by aorto-oesophageal fistula. This life-threatening condition causes gastrointestinal bleeding. It was the result of the infection from aortic aneurysm. We fixed it using a stent in the aorta and CT scans showed no further leakage of the oesophagus.”
No circulation in right leg
Even as the patient recuperated in the ICU, his health continued to pose challenges. Though he was responding to treatment, doctors noted that his right leg was not responding. “There was no pulse in his right leg. A thorough check-up found a complicated thrombosis in his femoral artery. He again underwent surgery to rectify that. There were multiple blood clots in his femoral artery. We cleared all those,” explained Dr Senthilnathan.
With timely intervention, his problems were resolved and the patient was discharged on April 7.
Timely admission saved life
Although the patient had no history of any illness or any comorbidities, he still faced a complex life-threatening situation. Dr Senthilnathan said: “It is very rare that a patient presents with such multiple complexities, each life-threatening by itself. Thankfully, he was brought [to hospital] at the right time and received proper treatment. We are so happy to see his recovery.
A relieved Shajikuttan told Gulf News: “I have no words to describe my feelings. I can only thank God and the doctors at Aster for giving me this second chance at life. I am looking forward to attending my daughter’s marriage. That is my only dream now. The doctors here have made that possible. My family and I will forever be indebted to them.”
