Showing posts with label heart attack. Show all posts
Showing posts with label heart attack. Show all posts

Monday, July 2, 2012

84-year-old man dies 2 weeks after fall

A fall at home last month landed 84-year-old Chiu Cho Tak at the emergency department of the Changi General Hospital.

Although his X-ray did not show any breaks, Mr Chiu was hospitalised.

Things went downhill after that.

After two weeks of being shuttled in and out of the intensive care unit (ICU) and the geriatric ward, Mr Chiu died from what was diagnosed to be a lung infection.

The episode left the family shaken.

"What I want to know is how this could happen and whether there was an over-treatment of my father's condition," said Mr Chiu's daughter, Mung Hing, 47, a businesswoman.

She had written in to The New Paper to share her story.

Relating the harrowing two weeks, Ms Chiu said her father slipped and fell at home when he was going to the toilet in the middle of the night.

He was rushed to CGH by Ms Chiu the next day after he complained of pain in his left leg.

On arrival, Mr Chiu was assessed by a doctor and sent to the X-ray department.

"Although the X-ray did not show any fractures, the doctors wanted to keep him for observation, in case he had a stroke," Ms Chiu said.

The family had wanted to take him home so they could get a second opinion, but was advised against it, she claimed.

Mr Chiu was warded.

During her father's first few days in the geriatric ward, a subsequent scan showed a small hip fracture.

Once again, the family expressed its wishes that the hospital discharge him so he could recover at home, but "the ward doctor insisted he should stay longer," Ms Chiu claimed.

The hospital, however, said that as Mr Chiu had suffered a fracture, his family's maid required caregiver training.

It added that doctors had made plans for Mr Chiu's discharge "together with his family". (See report on facing page.)

A week into his stay at CGH, Mr Chiu suffered a heart attack and was sent to the ICU.

Puzzled

"I was puzzled as to why the doctors at ICU insisted on putting a respiratory tube through my father when he could breathe normally on his own," Ms Chiu asked.

Four days later, Mr Chiu was transferred back to the geriatric ward, but started running a high fever.

He died on May 31 from lung infection.

"During his stay there, I saw at least seven doctors and every one of them gave me different information about my father's condition," said Ms Chiu.

She said she was asked at least six times if the family wanted to resuscitate her father should he collapse.

Ms Chiu said her father, despite his age, was still very alert, even though he "walked rather slowly".

Explaining her initial decision to take her father to the hospital, she said: "I wanted to make sure he was okay and there was no internal injury."

Ms Chiu said she later received a bill of $16,000 for her father's stay and treatment at CGH.

The hospital management and the doctors met with Mr Chiu's family for two hours on Thursday to explain his treatment.

Speaking to The New Paper after, Ms Chiu said CGH was sympathetic to her grief and during the discussion, "realised that there could have been a gap in communication".

Although she does not want to pursue the matter further, Ms Chiu hoped her father's experience would create awareness among the public and medical professionals alike.

What the hospital says

IN A written reply to The New Paper, Changi General Hospital said that Mr Chiu Cho Tak, 84, was admitted on May 17 through its Accident & Emergency department after his fall at home.

Its spokesman said that during Mr Chiu's stay at the geriatric ward, he was found to suffer from giddiness due to low blood pressure from lying down, and the hospital suspected it might have caused the fall.

He also had pain at the left side of his hip due to a fracture sustained from his fall. This was confirmed by a CT scan.

Doctors adjusted his medications to reduce giddiness and treated his pain, the spokesman said.

Mr Chiu was advised not to stand on the affected leg and to use a wheelchair instead.

As Mr Chiu had a fracture, he needed full assistance of a caregiver to move around.

Said the spokesman: "As such, the family's maid required caregiver training to enable her to look after Mr Chiu at home while the doctors made plans for his discharge together with the family.

"His daughter had requested for an early discharge on May 21 and it was planned for within a week of his admission but (as) his caregiver needed time to be trained, his daughter agreed with our plan to discharge him on May 25 instead," she added.

Throughout that period, Mr Chiu's vital signs were stable and he did not have any symptoms of chest pain, shortness of breath or palpitations.

But on May 24, he became acutely unwell and had a heart attack.

He was treated and referred immediately for further investigation and supportive treatment.

Procedures explained

The spokesman said Mr Chiu's daughter was present and the procedures were explained to her in the ward.

In light of his instability and decreased consciousness, Mr Chiu was intubated and sent to the Medical Intensive Care Unit (MICU).

The doctor spoke to the family about the option of not subjecting Mr Chiu to CPR (cardiopulmonary resuscitation) or advanced cardiac life support should his heart stop.

"This topic was broached respectfully and sensitively when the doctors assessed that further interventions are unlikely to produce any significant benefit for the patient. Mr Chiu's family was given time to discuss and consider, and his daughter signed the Do Not Resuscitate (DNR) form four days later," the spokesman said.

"Although the form was signed, our doctors will still check with the family on their wishes thereafter as we understand the sensitivity of a DNR," she added.

Mr Chiu was transferred to the general ward after four days at the MICU, when his condition improved and he was able to breathe without ventilatory support.

"Our doctors remained guarded in their prognosis and this was conveyed to his daughter.

"Mr Chiu was also receiving treatment for an ongoing infection after having fever, and subsequent X-rays revealed a pneumonia which progressed rapidly despite maximal medical therapy," she said.

Unfortunately, Mr Chiu's condition deteriorated o nMay29 and he died two days later.

"Throughout his stay, our doctors had constantly kept his family, especially his daughter, informed of his condition. Our doctors work in a team and although different membersof the team have spoken to the family throughout the admission, the medical team was always clear about the medical management plan," the CGH spokesman said.

She added that the Geriatric Medicine Consultant in-charge, who is the primary doctor, managed MrChiu with his colleagues and updated his daughter.

Other specialists included the bone specialists and cardiologists.

On the meeting with the family on Thursday, the spokesman said the hospital "has given her (Ms Chiu) a clearer understanding of the treatment provided for her father and addressed all her concerns in detail".

"We assured her of the commitment of our medical team and the specialists who took care of her father," she said.



Thursday, June 21, 2012

Insurance manager, 37, dies of heart attack after football game

Left:Mr Wan Hussin Zoohri, former Aljunied GRC Member of Parliament (MP), showing his mobile phone with a picture of his youngest child, Mr Wan Imran Haji Wan Hussin. Right: Mr Wan Imran.

They waited for him to reach home so they could have dinner together on Father's Day.

But he never made it.

On Sunday evening, former Aljunied GRC Member of Parliament (MP) Wan Hussin Zoohri's son, Mr Wan Imran Haji Wan Hussin, died of a heart attack after playing football.

The 37-year-old manager at an insurance firm had earlier shown signs of being unwell.

His brother-in-law, Mr Alif Lim, 50, a civil servant, told The New Paper that Mr Wan Imran had met his usual group of football "kakis" at 5pm to play at Yusof Ishak Secondary School.

"While playing, he felt uncomfortable and went to the toilet to vomit. When he returned, he asked a friend to take him home," saidMrLim Mr Wan Imran lost consciousness on the way back, on Tagore Drive, near Upper Thomson Road.

"His friend said he had fits, before becoming unconscious," said Mr Lim.

His friend immediately called for an ambulance.

The Singapore Civil Defence Force (SCDF) said it received a call for assistance at about 7.20pm, and sent an ambulance.

The officers performed CPR (cardiopulmonary resuscitation) and used an automated external defibrillator on Mr Wan Imran, before taking him to Khoo Teck Puat Hospital (KTPH). They continued with their resuscitation efforts en route.

Mr Lim said they were praying at home when they received a call from Mr Wan Imran's friend.
Together with his wife, her parents and two brothers, he rushed to KTPH.

Mr Wan Imran, the youngest of four siblings, was declared dead at 8.36pm.

Never complained of chest pain 

"According to his friend, he was one of the fittest in the group, and would chase every ball," said Mr Lim.

He said Mr Wan Imran's death was completely unexpected, as he never once complained of any chest pains nor had any records of medical problems.

The family is coping well, with support from relatives and friends.

Mr Wan Hussin, who was also former Parliamentary Secretary for Health and Culture, said his youngest son was a pleasant person who respected every one.

"We are closely knit. We gather at home for dinner every weekend and my wife would cook," he said.

He described his son as an ambitious man who wanted to climb the corporate ladder.

"He was promoted this month. We would tease him every morning and call him 'Mr Manager'."

Mr Wan Hussin said his wife had taken the shock better than him.

"From the time he was lying in hospital until the burial, I couldn't stop crying. When I see his face, it just reminds me of his gentleness," he said.

He recalled how his son had given him a back massage before leaving on Sunday.

"My back had been uneasy for two days, so before he went out, he gave me a really good massage. I really enjoyed it," said Mr Wan Hussin.

Coping well 
 
"That was the last time I saw him alive."

Mr Wan Imran's best friend, Mr Sujen Jayakody, 36, flew in from Sydney, Australia.

Said the medical doctor, who has been based overseas for six years: "We've known each other since our primary school days at St Michael's School (Now St Joseph's Institution Junior)."

As soon as he got the news, he went online to book a flight to Singapore .

He arrived at 2.30pm yesterday and made it to Choa Chu Kang Muslim Cemetery in time for the burial.

"He was a really cheerful person. He was very quiet, so it would take a while to get to know him. But once he warmed up, he would liven up the room," Dr Jayakody said of his friend.

The last time the two met was when he returned from Australia 11/2 years ago.

They kept in touch regularly through Facebook.

"On his last birthday on March 3, he told me that of all the texts and wishes he received, he cherished the one I sent him the most," Dr Jayakody said.

"He's like the brother I never had."

No symptoms till disease is severe 

Cardiologist Soon Chao Yang said coronary atherosclerosis is a disease that leads to blockage of blood vessels of the heart.

"It is not uncommon as everybody eventually will develop it with ageing. Some will get it faster than others," said Dr Soon of Nobel Heart Centre, based at Mount Alvernia Hospital.

He added that there are generally no symptoms until the disease becomes severe.

"Unfortunately, the more severe cases sometimes end up in sudden attacks, such as in this case here," said Dr Soon.

He said factors that lead to this condition include elevated cholesterol, high blood pressure, obesity, smoking and diabetes.

"To keep all these factors in check, we have to lead a healthy lifestyle and screen for them regularly," he said.

But there are also factors beyond our control, such as gender, ethnicity and family history.

"It is more common in guys, and woman have lower risks until after menopause," he said.

Several social footballers in Singapore have died from heart attacks, but even professionals have not been spared.

They include:
  • PIERMARIO MOROSINI, APRIL 14, 2012: The 25-year-old midfielder, who played for Italian club Livorno, fell to the ground in a Serie B match. He received urgent medical attention on the pitch but never regained consciousness, and was dead by the time he was taken to hospital. 
  • DANIEL JARQUE, AUG 8, 2009: The captain of Spanish side Espanyol died after a cardiac arrest following pre-season training. Club doctors and paramedics tried to revive the 26-year-old midfielder using CPR and a defibrillator, without success.
  • ANTONIO PUERTA, AUG 28, 2007: The wing-back of Spanish club Sevilla collapsed in the 35th minute of a La Liga match against Getafe on Aug 25, 2007. The 22-year-old was able to walk from the pitch but collapsed again in the changing rooms. He had to be given cardiac resuscitation before being taken to hospital. He died three days later.


Thursday, March 15, 2012

22-year-old woman's heart stopped 31 times

At 22, she suffered a cardiac arrest.

And after the woman was sent to hospital, her heart stopped another 30 times.

Thankfully, she survived.

Book editor Samantha Yong, now 23, suffered the cardiac arrest at home in the Telok Blangah area in January last year.

The Singaporean was getting ready for work that day when she suddenly fainted.

She told The New Paper yesterday: “I didn’t really feel or remember anything about the incident.”

A few days before the episode, Ms Yong had felt heart palpitations. But she didn’t pay attention to it.

“I didn’t have any pre-existing health condition. So it really took me by surprise,” she said.

When she fell in the bedroom, she knocked over a fan, and this woke up her then boyfriend, identified only as Michael.

The American, a computer programmer, now 25, saw Ms Yong lying unconscious on the floor.

She looked pale and her lips were blue. But she had a pulse.

So Michael immediately called for an ambulance and conducted cardiopulmonary resuscitation (CPR) on her.

He had learnt this in high school, but had not performed it on anyone in about 10 years.

Said Ms Yong: “He was really scared and panicky. He had to talk himself through the steps to calm himself down.

‘He really saved my life there’

“He really saved my life there. Without him, I won’t be here.”

When the paramedics arrived, they found Ms Yong’s heart beating erratically.

Using a defibrillator, they gave her an electric shock, which restored her heartbeat to normal.

Ms Yong was sent to the accident and emergency department at Singapore General Hospital.

But there, her heart stopped another 30 times. Each time, the doctors revived her.

And finally, her condition stabilised.

She was admitted to the cardiac care unit at the National Heart Centre, where she had an operation to have an automated implantable cardioverter defibrillator inserted into her chest.

This battery-powered device can monitor a patient’s heart rhythm constantly.

When this rhythm is abnormal, the device administers electric shocks to correct the abnormalities.

Ms Yong was discharged 10 days after being admitted. She returned to work in March last year.

She said: “I still don’t really know the cause of the arrest. My doctors think it might be a genetic condition, but I can’t be sure.

“They are still researching and monitoring me.”

Nonetheless, the people around Ms Yong have taken precautions just in case the incident happens again.

Michael, now her husband, has installed several corner protectors around the house so she won’t hurt herself if she falls again.

Her publishing company, World Scientific, also installed an automated external defibrillator (AED) in the office.

An AED is an external device which can help restore a normal heartbeat by delivering electric shocks.

Course in CPR

Ms Yong’s colleagues had also volunteered to take a course in CPR and first aid.

About 20 of her colleagues took the course last July, which was conducted over a few weeks.

Said Ms Yong: “I’m very lucky to have such supportive family members and friends. My colleagues were the ones who arranged for an instructor to come in.

“I’m so touched by what they did.”

A cardiologist, Dr Soon Chao Yang, told The New Paper that it is very rare for a 22-year-old woman to suffer a heart attack.

There is less than a 1 per cent chance of someone like Ms Yong having such an attack, said the medical director of Nobel Heart Centre, which is under the Healthway Medical Group.

“Patients her age usually have other health problems – like diabetes or an auto-immune disease – that prompt heart problems to develop at such a young age.

“Sometimes, heart attacks can be due to just stress,” added Dr Soon.

He said that during a heart attack, it is not uncommon for a person’s heart to repeatedly go into an abnormal rhythm.

He said: “During the episode, the heart is injured, unstable. It is not ‘happy’. So it can stop again and again, even up to 20 times.

“It’s like a storm that keeps coming. Thankfully, this happened in the hospital, where the doctors can revive the heart pretty quickly.

“If she was out of the hospital, she would probably have died.”

The best time to deliver the shock

The Singapore General Hospital (SGH) will conduct the world’s first trial to determine when is the best time to deliver electrical shocks to patients who suffer heart attacks.

SGH doctors will investigate if delivering this shock at a specific time during cardiopulmonary resuscitation (CPR) can improve the patients’ chance of survival. Cardiac arrest patients who are taken to its emergency department with severely abnormal heart rhythm are eligible for the study.

They may be enrolled into it from next month.

Currently, patients who have cardiac arrests are given CPR and shocks to their hearts immediately. The CPR is paused when the shock is delivered.

But with the advent of automated CPR machines, pauses can be avoided and the shock can now be synchronised with CPR.

SGH’s doctors hope this arrangement can increase shock success, as shown in animal studies.
The study aims to enrol 142 patients, to be randomly divided into two groups.

In each group, the automated CPR machine and defibrillator will be programmed to give a shock at a different time during the chest compression.

In one group, patients will be given the shock during a point when pressure is taken off the chest. In another, patients will be shocked at the pre-compression phase, which is the current standard of care.

The pre-compression phase is the period between each complete chest compression.

The study is led by Associate Professor Marcus Ong, a senior consultant at SGH’s department of emergency medicine. He said: “We want to increase patients’ chances of survival. This study has the potential to significantly impact current practice of resuscitation.”

Heart attacks are totally unpredictable and can strike anyone anywhere and at any time.

Cardiac arrests

According to a Straits Times report, more than 1,000 cardiac arrests happen in Singapore every year.

SGH alone sees 150 to 200 such patients each year.

In Singapore, only 2 per cent of these patients survive. In the US, Europe and Japan, this figure is 20 per cent.

In general, conducting CPR immediately on a patient doubles his or her chances of survival.

SGH is organising a community forum this Saturday to inform the public about the study and teach them what to do if they encounter someone suffering a heart attack.

The free event, Surviving a Cardiac Arrest: What You Need to Know, will be held in the SGH at Block 6, Level 9, from 2pm to 4pm.

The forum will be conducted in English.
 

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