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Urgent help regarding severe syncope resulting in cessation of breathing & heartbeat

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    Urgent help regarding severe syncope resulting in cessation of breathing & heartbeat

    Hi,
    We had faced the most devastating situation on 8th November 2009 when my husband suffered sudden & extreme drop in blood pressure & breathlessness, resulting in an immediate death within a period of few seconds/minutes. We only brought him back by providing mouth to mouth resuscitation. When the medical care was available after 15 minutes his blood pressure was found to be 50/?. Just before this happened he had defecated himself in a large quantity in the bed after taking suppositries with the help of an attendant. Soon after that he performed intermittent catherterisation in a sitting position during which he developed a bronchospasm/muscular spasm beneath his chest . Due to this he was having extreme breathng diificulty/cessation of breath & turned pale . Within a minute or two he was shifted to the bed , his foot end was raised, during which he immediately collapsed with no breathing or heartbeat. Mouth to mouth resuscitation was given to him by me immediately, which revived him.
    He was then hospitalised & admitted at the Coronary Care Unit. The doctors diagnosed him as a Survivor of Sudden death due to cardiac arrest. However, all of the following blood tests were normal:-
    1) LFT
    2) RFT/Electrolytes
    3) Lipid Profile
    His ECG, EEG, Cardiac-Eco, Trop-I, B/L Carotid Doppler/Halter were also normal. Nuero consultation was also sought. He is adviced AICD (Internal Cardiac Defbrillator) implant.

    I would like to describe my husband's condition prior to this incident. He had obtained a spinal cord C7 injury in the year 1981 at the age of 21 years , while diving in a swimming pool. After which he was completely rehabilitated & was leading a wheelchair led normal life. Ofcourse he suffered the related problems like Urinary tract infections, mild syncopes, cellulitis on an on & off basis which were all duly treated.
    He has now been discharged ffrom the hospital & the doctor has adviced a ICD implant as he describes that it would be an insurance for him.

    Since in India we have very limited expertise pertaining to spinal cord injury patients , we desperately seek to know whether this is the best suited line of treatment. Also, we have not recieved any advice on how to prevent such a situation from occuring agan. We feel very lost.
    We will be greatly obliged if we can get an urgent consultation on this matter.

    We request the doctors who are spinal cord injury specialists to advice us.

    Thanks
    Nalina
    Last edited by nalina; 16 Nov 2009, 3:17 PM.

    #2
    It does not sound like this is really a SCI related event, although indirectly it may be as people with SCI are more subject to cardiac disease at younger ages. It sounds like you are getting good advice about the AICD and probably should proceed with this plan. It is more likely from what you describe that he has not had actual cardiac arrest, but instead cardiac ventricular fibrillation, which appears often the same, and repeated episodes of this are generally treated now days with an AICD implant (not transplant).

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      Nalina,

      I'm under the impression that you are describing Pure Autonomic Failure, something that I can induce with excessive physical activity or being in a room where the temperature is rising and the Oxygen level is decreasing. These are the most dangerous to me but voiding is also on the list. I remove all of my clothes, shoes before a bowel movement to mitigate the episode. I too have the upper abdominal muscle spasm that you describe that is aggravated by the visceral distention from sitting upright. Pallor is another symptom of a exaggerated response from the Autonomic Nervous System. Was there piloerector and hyperhydrosis observable during this episode? I would also test for Orthostatic Hypotension.

      Joe

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        #4
        Nalina - I have no advise for you, just wanted to say your husband is very lucky to have you on his side. Way to go, without your quick reaction this could have turned out so different. I think all of us as caregivers should know CPR. Keep up the good work. - Lisa

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