A 44-year-old man, previously healthy with no history of smoking or cardiovascular disease, experienced sudden cardiac arrest at Bach Mai Hospital's A9 Emergency Center in Hanoi. He had initially presented with mild chest pain. While waiting for test results, he collapsed, losing consciousness and suffering circulatory arrest.
Upon his arrival, clinical examination showed stable vital signs: pulse 90 beats per minute, blood pressure 120/80 mmHg. Doctors detected no arrhythmia or heart murmur. The electrocardiogram did not clearly suggest coronary artery damage or myocardial infarction. He underwent basic blood tests and had troponin T levels measured, with the plan to consider discharge for home monitoring if results were normal.
When he collapsed, doctors immediately initiated chest compressions. The monitor showed ventricular fibrillation. The patient received three defibrillation shocks, was intubated, and cardiopulmonary resuscitation continued. After about 15 minutes, his pulse returned, and spontaneous circulation was restored.
Suspecting a cardiovascular cause for the ventricular fibrillation, the medical team held an urgent consultation. They transferred the patient for coronary angiography and intervention. The angiography revealed a left anterior descending artery (LAD) myocardial bridge with 99% stenosis in the coronary segment distal to the bridge. This lesion was identified as the cause of the malignant ventricular arrhythmia. The patient successfully received an LAD stent.
Following the intervention, the patient was transferred back to the recovery room. He underwent 48 hours of targeted temperature management, received sedation, mechanical ventilation, hemodynamic support, and had risk factors controlled. After the hypothermia therapy, he regained consciousness, was extubated, and fully recovered without any sequelae.
Associate Professor Nguyen Anh Tuan, Director of the A9 Emergency Center, described this as a "hidden" and dangerous case. He noted the man's symptoms were subtle, and a standard electrocardiogram showed no abnormalities. Doctor Tuan emphasized that youth does not guarantee immunity from cardiovascular disease. He urged people to seek specialized screening even for minor chest pain, as basic tests sometimes fail to detect hidden lesions.
Le Nga
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