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Sep 02,2023

90 minutes to escape the ''Door of death'' of a patient with acute myocardial infarction


Acute myocardial infarction is a life-threatening condition caused by an acute coronary syndrome (ACS). If the large infarct area is complicated and there are symptoms such as heart failure and  acute pulmonary edema, the situation is even more dangerous.

Blockage of one coronary artery is dangerous, but when multiple coronary artery branches are damaged, especially if there is damage at the origin of the coronary artery, the patient's likelihood of death is very high. High-risk cases are extremely difficult to treat, requiring doctors with many years of experience and timely, modern emergency intervention methods to save the patient's life.

At 11 p.m. on August 28, 2023, Mr. T.V.P (born in 1955 and residing in Can Tho) suddenly developed chest pain that felt like suffocation, which was slightly relieved with rest. However, at 5 a.m. on August 29, 2023, the patient had continuous chest pain, so his family immediately took him to the Emergency Department - HSTC - CĐ, Nam Can Tho University Hospital for monitoring and treatment.

The process of performing coronary intervention at Nam Can Tho University Hospital.

Photo: DNC Studio

Here, the patient had chest pain, difficulty breathing, wheezing, had to sit and breathe, and skin was sweaty. First aid was given, an oxygen mask was established, an infusion line was established, echocardiography and electrocardiogram were performed, showing signs of acute anterior myocardial infarction. The diagnosis results were acute myocardial infarction with anterior ST elevation and symptoms of severe heart failure (EF 30%), as well as acute pulmonary edema. The patient was treated with anticoagulants, antiplatelet drugs, diuretics, and intravenous infusion of vasodilators. When the patient was temporarily stable, emergency coronary intervention was performed.

The DSA scan result before intervention for patient T.V.P. Photo: DNC Studio

The patient was taken to the DSA interventional room by doctors of the Department of Cardiology and Cardiovascular Intervention for emergency coronary angiography and intervention. The results showed severe narrowing of the coronary artery at the origin of the LM and severe narrowing of all three coronary artery branches. Two of the large branches on the left (LAD and LCX) were narrow, long, diffuse, and had slow-flowing blood, posing a risk that the heart could stop beating at any moment.

Doctor Tran Chi Dung, a Second Degree Specialist, directly explained and clearly stated some risks that the patient may encounter. Photo: DNC Studio

After explaining clearly the patient's condition to the family, the team intervened and, after 90 minutes of intervention, they saved the patient's life before the situation became dangerous. After the intervention, the patient’s had chest pain gone, his breathing was easier, no oxygen mask was needed, and his vital signs were stable. The patient continued to be monitored for treatment at the Department of Cardiology and Cardiovascular Intervention, Nam Can Tho University Hospital.

The results of coronary revascularization for the patient T.V.P. Photo: DNC Studio  


Doctor Tran Chi Dung, a Second Degree Specialist and Permanent Deputy Head of the Department of Cardiology and Cardiovascular Interventions, shared: “This case was considered very critical; cardiac arrest could occur at any time. Fortunately, the patient was brought to the hospital promptly and, with the consent of his family, while there’s life, there’s hope. The hospital's Cardiovascular Intervention team quickly performed vascular intervention on the patient. The golden time for vascular intervention is very important, and fortunately the patient had overcome the critical condition."


This article was written in consultation with Doctor Tran Chi Dung, a Second Degree Specialist and the Standing Deputy Head of the Department of Cardiology and Cardiovascular Intervention, Nam Can Tho University Hospital.




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