Having suffered an acute heart attack five months prior, Hai recognized the recurrence by the crushing chest pain in his precordial region, radiating to his left shoulder, accompanied by shortness of breath. After resting briefly, he decided to drive his family back to TP HCM for medical examination, instead of calling emergency services (115) or going to the nearest hospital.
Traveling approximately 200 km from Phan Thiet, Hai arrived at Tam Anh TP HCM General Hospital for emergency care over two hours later. Dr. Ton Minh Tri, Head of the Emergency Department, noted the patient's fast pulse of 100 beats per minute, pale complexion, and sweating. An electrocardiogram revealed signs of an extensive acute anterior heart attack.
Troponin I enzyme tests showed a level of 422 ng/L, tens of times higher than the normal threshold (below 14 ng/L), indicating acute cardiac damage typical of a heart attack. An echocardiogram revealed reduced movement in the anterior septal wall and reduced pumping function of the heart.
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The medical team quickly provided emergency care to Hai. Photo: Tam Anh General Hospital |
The medical team quickly provided emergency care to Hai. Photo: Tam Anh General Hospital
"This was a heart attack at the sixth hour, requiring urgent coronary revascularization," Dr. Tri stated. A coronary angiogram showed that a stent placed in March was functioning well, but another branch of the coronary artery was 90% narrowed. Doctors performed balloon angioplasty and inserted an additional new stent, fully restoring blood flow and maximizing salvage of the myocardial tissue.
Following the intervention, Hai received dual antiplatelet therapy, cholesterol medication, blood pressure drugs, and underwent blood sugar control while maintaining a suitable diet and exercise regimen. He was discharged after five days of treatment, his health stable.
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Doctors placing a stent to revascularize the patient's coronary artery. Photo: Tam Anh General Hospital |
Doctors placing a stent to revascularize the patient's coronary artery. Photo: Tam Anh General Hospital
"The patient was fortunate not to experience an incident on the road. Driving oneself with heart attack symptoms is risky and should not be attempted," Dr. Tri warned. When driving long distances, a patient could suffer cardiac arrest or lose consciousness, endangering themselves, their family, and other road users.
Hai explained that he "felt well enough to drive, so he tried to return to TP HCM for hospitalization."
Doctors advise that upon experiencing severe chest pain radiating to the arm or jaw, accompanied by shortness of breath, sweating, or nausea, patients should immediately cease all activity. They should call emergency services (115) or go to the nearest hospital capable of coronary intervention. Long-term treatment adherence is crucial, including regular medication, scheduled follow-ups, controlling blood pressure, blood sugar, and blood lipids to target levels, maintaining a low-salt diet, limiting fats, quitting smoking, and moderating alcohol consumption. Physical activity should be appropriate for one's capacity, avoiding sudden exertion.
Early recognition of a heart attack is vital for patient survival. Common symptoms include severe chest pain, a crushing or heavy sensation behind the breastbone, pain that may spread to the left shoulder, arm, neck, or jaw, accompanied by shortness of breath, cold sweats, nausea, vomiting, dizziness, fatigue, or palpitations.
In women, the elderly, and diabetic patients, symptoms can sometimes be atypical, easily mistaken for digestive issues or general fatigue, presenting as epigastric pain (above the navel), indigestion, or unusual exhaustion.
