Suffering from "broken heart syndrome", woman had 2 cardiac arrests

(Dan Tri) - On October 28, Cho Ray Hospital announced that it had coordinated with Tu Du Hospital to treat a female patient with a rare "broken heart" syndrome, causing her to stop her heart twice.

Cardiac arrest 2 times critical

Previously, on October 17, Cho Ray Hospital (HCMC) received a consultation invitation from Tu Du Hospital regarding the case of female patient VTB (42 years old, residing in Dak Lak ) who suffered from cardiac arrest twice during surgery to treat a disease, and was actively resuscitated by doctors at the Obstetrics Department.

Immediately, the team from the Cardiology Department of Cho Ray Hospital moved to the neighboring unit to assess the patient's condition. According to the initial diagnosis, the woman was in severe cardiogenic shock and needed emergency circulatory support.

The patient was quickly intubated, ventilated, maintained minimal hemodynamics and transferred to Cho Ray Hospital in critical condition. In the cardiovascular resuscitation room, the patient was recorded as having severe cardiogenic shock, very high cardiac enzymes, and normal coronary angiography results.

Woman in Dak Lak had 2 critical cardiac arrests (Photo: Hospital).

Ultrasound image shows a non-moving apex but hyperactive base, ejection fraction reduced to only about 33%.

This is a typical form of Takotsubo disease - a type of stress-induced cardiomyopathy also known as "broken heart" syndrome, which is easily confused with acute myocardial infarction and can progress rapidly, leading to acute circulatory failure.

Faced with the critical situation, the team of the Cardiology Department consulted with the Interventional Cardiology Department and the Emergency Department of Cho Ray Hospital, and decided to activate the 24/7 extracorporeal heart-lung support procedure, install the ECMO system, and create a "window" for the heart muscle to recover.

In parallel, a comprehensive resuscitation strategy, hemodynamic control, lung-protective ventilation, recommended antibiotics, and multi-organ support were implemented. Thanks to a good response to intensive treatment, the patient's blood pressure and cardiac activity gradually stabilized.

The patient was gradually tapered off the ventilator and weaned off the cardiopulmonary bypass system. Bedside echocardiography showed that the heart's contractility (ejection fraction) increased by 38% immediately after the support was removed, and continued to improve in the following days.

After 10 days of treatment, the patient's endotracheal tube was removed and he was switched to oxygen therapy through a cannula. His vital signs were stable and his vital signs recovered well, escaping the "near-death" situation.

The patient was found to have "broken heart" syndrome (Photo: Hospital).

Very rare clinical case

Associate Professor, Dr. Hoang Van Sy, Head of the Department of Internal Medicine and Cardiology, Cho Ray Hospital, said that this was a case of Takotsubo cardiomyopathy with a very severe and sudden progression. Drugs used in conventional cardiopulmonary resuscitation such as vasopressors are contraindicated in this case.

The key to treatment comes from timely inter-hospital coordination between Cho Ray Hospital and Tu Du Hospital.

Associate Professor Sy analyzed that "broken heart syndrome" can be triggered by physical or psychological stress, especially in patients undergoing major surgery. However, less than 10% of cases lead to acute circulatory failure. Therefore, this is a very rare clinical case.

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) allows for the maintenance of organ perfusion when the heart fails, thereby creating conditions for the heart muscle to rest and recover. In addition, early recognition and appropriate intervention also play a decisive role in the success of the case.

The patient has overcome the critical stage after being put on ECMO and receiving intensive treatment (Photo: Hospital).

Experts warn that cardiovascular diseases are increasingly diverse and unpredictable, and can appear in situations of physical or mental stress.

Therefore, women - especially in the pre- and post-menopausal stages - need to be vigilant when experiencing symptoms of chest pain, shortness of breath after physical and mental stress, or after surgery. These could be signs of dangerous cardiovascular diseases such as myocardial infarction or "broken heart" syndrome.

Cases of Takotsubo cardiomyopathy with severe cardiogenic shock complications require care and treatment at centers capable of performing mechanical circulatory support techniques (such as extracorporeal cardiopulmonary support systems).

Previously, on October 27, for the first time, Saigon General Hospital and Gia Dinh People's Hospital (HCMC) coordinated to implement the inter-hospital E-CPR procedure, helping to save the life of a critically ill patient.

The patient was a 69-year-old woman who had diarrhea and vomiting for a day. On the way to Saigon General Hospital, she suddenly had cardiac arrest, stopped breathing, and lost consciousness.

Immediately, doctors at Saigon General Hospital performed cardiopulmonary resuscitation (CPR) on the patient, but the patient's circulatory arrest showed no signs of improvement.

Recognizing that the cause could be acute myocardial infarction causing out-of-hospital cardiac arrest, Saigon General Hospital activated the inter-hospital E-CPR procedure with Gia Dinh People's Hospital.

The ECMO team of the Cardiovascular Intensive Care Unit, Gia Dinh People's Hospital, was immediately present to perform the VA-ECMO technique. About 15 minutes later, the patient's circulation and consciousness showed signs of recovery.

At this time, doctors from the two hospitals coordinated to transport the woman to Gia Dinh People's Hospital for further intensive resuscitation. Here, the patient underwent an emergency coronary angiogram and was found to have multiple blood clots - the main cause of cardiac arrest before admission.

After having a coronary stent placed and maintaining extracorporeal circulation, the patient was conscious and is currently continuing to be resuscitated in the Cardiovascular Intensive Care Unit.

Source: https://dantri.com.vn/suc-khoe/mac-hoi-chung-trai-tim-tan-vo-nguoi-phu-nu-2-lan-ngung-tim-20251028160405408.htm