Saturday, February 24, 2018
Opinion

Cardiac arrest need not be end

That particular name on the patient schedule for that afternoon lifted my spirits. I was looking forward to seeing her.

I walked into the room and greeted her with a gentle handshake. She got up and greeted me with an affectionate hug. As she was getting onto the exam table, she began chanting "four more years, give me four more years."

It reminded me of election season. "What are you running for?" I asked.

She didn't hold any office and she wasn't a candidate — at least not for political office. I opened her chart and noticed her age, 96. Suddenly I got it . She wanted to live to be 100. She was a candidate for centenarian.

I am sure she will be successful. I am sure she will live to 100 and beyond. She is in good shape: Active, sharp and always happy. She is very compliant and never complains.

I met her for the first time about 26 years ago. It was 4 a.m. in the emergency room. She had just died.

You read that right. I came to the emergency room to see a patient having a heart attack. I saw the E.R. team resuscitating a patient who went into cardiac arrest in the ambulance on the way to the hospital. I went to see my patient in the next room, relieved to know that he was doing fine.

But, I overheard the E.R. physician say, "call it off." I peeked in and asked whether I could give a hand. We were able to revive her. She became one of my heart patients and now has ambitions to hit the century mark. She has done well for the past 26 years, with appropriate treatment.

Sudden cardiac death is responsible for approximately 300,000 fatalities in the United States annually and an estimated 7 million worldwide. Most result from an unexpected heart attack.

Lack of blood flow to part of the heart muscle causes electrical irritability and causes the heart to fibrillate or quiver. It can also happen in people with a scar from a previous heart attack or in people with heart failure from a weak heart. If not restored to even rhythm with an electric shock, within a few minutes, the heart stops (cardiac arrest) and the patient dies. With each passing minute after the onset, the likelihood of survival is reduced by 7 to 10 percent. Even if the heartbeat is restored after seven minutes, without chest compressions (CPR) to maintain blood flow to the brain during that time, the patient can become brain dead.

According to the American Heart Association, half of the men and nearly two-third of the women who die suddenly of coronary heart disease have no previous symptoms.

Prevention of sudden cardiac death involves prevention of heart disease in the first place by controlling well-known risks. Early discovery and adequate treatment of heart disease with medications and interventions (stents or bypass surgery) play a pivotal role.

If sudden cardiac death occurs outside a hospital, prompt bystander CPR using chest compressions, urgent electric shock from an automatic external defibrillator and availability of an ambulance to transport the patient to the hospital improves chances for survival dramatically.

Every man, woman and child should learn to do CPR. Most sudden cardiac deaths occur at home. Every public or private place where people routinely gather should have a functioning defibrillators and trained personnel. All police vehicles and fire trucks should have them also.

After 26 years, my patient keeps praising me all these years for saving her life. I explain each time that it was pure destiny that we met at the right time, at the right place, even though both of us reached Hudson from the opposite sides of the globe.

She owes her gratitude to her maker, not to me. So, is there life after death? I have one patient who says, yes, most definitely. She has a good one, right here on Earth.

Heaven can wait. She's still on her campaign trail for at least four more years.

Dr. Rao Musunuru, a cardiologist, has treated Pasco and Hernando patients for more than 30 years. He received the American Heart Association's national physician of the year award in 2005.

Comments
Editorial: Improve school security plans with gun controls

Editorial: Improve school security plans with gun controls

Gov. Rick Scott and key members of the Florida Legislature offered ambitious proposals Friday that would plug some holes in the stateís safety net, strengthen school security and spend up to a half-billion dollars in response to last weekís massacre ...
Published: 02/23/18
Editorial: Six proposals for reasonable gun control

Editorial: Six proposals for reasonable gun control

Enough is enough. The mass shooting at Marjory Stoneman Douglas High School has renewed conversations about gun control in Washington and Tallahassee. Young people are demanding action, and there are cracks in the National Rifle Associationís solid w...
Published: 02/23/18
Editorial: The time to act on guns is now

Editorial: The time to act on guns is now

The nationís conversation on guns took an encouraging step this week in three essential places ó South Florida, Tallahassee and Washington ó as survivors, victimsí families and elected leaders searched painfully and sincerely for common ground after ...
Published: 02/22/18

Editorial: FDLE probe of state fair fiasco falls short

It should go without saying that Florida law frowns upon public officials who take freebies from vendors and whose agency throws business to their family. But that wasnít enough to move the Florida Department of Law Enforcement to find that the ex-di...
Published: 02/21/18
Updated: 02/23/18
Editorial: They value guns, not kids

Editorial: They value guns, not kids

They value guns over kidsSix days after 17 were killed at Marjory Stoneman Douglas High by a teen-ager firing an AR-15 semi-automatic rifle, the Florida House refused to even debate a bill banning the sale of assault weapons. The vote, 71 to 36, wasn...
Published: 02/21/18

Editorial: Nursing home rule should be stronger

It shouldnít take months or another tragedy for Florida ó which is hot and full of seniors ó to protect its elderly population from heat stroke in the event of an emergency. Thatís why Gov. Rick Scott had the right idea last year in calling for nursi...
Published: 02/20/18
Updated: 02/23/18
Editorial: Listen to Marjory Stoneman Douglas students demanding change

Editorial: Listen to Marjory Stoneman Douglas students demanding change

Students from Marjory Stoneman Douglas High School are traveling to the state capital today and declaring "never again.íí A prominent Florida Republican fundraiser vows he wonít raise another nickel until his party approves new gun controls. Across F...
Published: 02/19/18

Editorial: No more doubt about Russian meddling in election

The latest indictment by the Justice Department special counsel, Robert Mueller, refutes President Donald Trumpís claims that Russian interference in the 2016 election was a Democratic hoax. The indictment details the lengths Russian conspirators too...
Published: 02/19/18

Another voice: Tips should belong to workers, not their bosses

The Trump administration is under fire for proposing a Labor Department regulation that could result in hotel and restaurant employers dipping into the tips customers leave for their employees, depriving the nationís 14 million hard-working restauran...
Published: 02/18/18
Updated: 02/20/18
Editorial: Trumpís rising deficits and misplaced priorities

Editorial: Trumpís rising deficits and misplaced priorities

Itís not popular in Washington or virtually anywhere else these days to express concern about the rising federal deficit. Congressional Republicans who used to be deficit hawks first voted to cut taxes by $1.5 trillion over the next decade, then rais...
Published: 02/17/18