Lost my Father-In-Law Last Night

RocketMedic

RocketMedic

Californian, Lost in Texas
Messages
4,997
Reaction score
1,462
Points
113
To a total LCA occlusion. Backstory, he was a long-haul trucker, smoker, and had a long history of angina. Attempted cardiac catheterization on Monday failed, arteries were too occluded to stent or clean, lesion was present and calcification was fairly extreme. Admitted to hospital after ER walk-in, open-heart scheduled, MI yesterday morning, aortic balloon pump implanted, heparin drip started along with preop- and in twenty minutes, he went from 110/80 x P65 x SaO2 97% and no pain to Vtach and "impending doom" to pulseless, despite dopamine 20mcg/kg/min and ACLS for nearly an hour, with no ROSC. Per the attending, it was most likely a shifted clot from the balloon pump.

End lesson? Don't trust the ECG. Although the hospital and the doctors did their best and the right thing, I can easily have seen myself putting this patient in a 'less critical than they really are' box. Even with no signs and symptoms manifesting, these patients are still critical.

It was a learning experience. A horrible one, but hopefully I'll recognize it later and make a difference.
 
So sorry to hear that. We are dealing with bad CAD with my dad and it's just scary.
 
Thoughts and prayers to yall right now.
 
Just lost my dad in August. My thoughts are with your wife, her family and you during this difficult time.
 
I'm sorry to hear about your father-in-law. My thoughts are with you and your family. I hope your wife is doing okay. Losing a father is hard.
 
Be understanding with your wife. She needs you but may not treat you the way you expect during this time.

Wish you both well.
 
So sorry for your loss. Thoughts and prayers to you and your family.

But it brings up a couple valid points:

- History is worth a lot, even with a presentation that isn't textbook, or even highly suspicious.

- A clean EKG does not rule out acute coronary syndrome.

Excellent post. Thank you for taking the time to share with us.
 
My thoughts are with you and your family.

As terrible of an event as it is you managed to make lemonade out of lemons and learn something, good for you!
 
Sorry for your loss.

Very difficult to take something positive away from such tragedy but thank you for sharing.
 
Sorry for your loss and thank you for sharing that. It helps to read cases like this to keep up a high index of suspicion.
 
I apologize for the dumb question, but was his ekg clean? You said don't trust the ekg, but I missed why.

Sorry for your family's loss. :-(
 
Aidey said:
I apologize for the dumb question, but was his ekg clean? You said don't trust the ekg, but I missed why.

Sorry for your family's loss. :-(
Click to expand...

Not dumb, it threw me off too. Classic, textbook normal sinus. No aberrency, no ectopy, no changes. Good, healthy NSR straight into pulseless Vtach.
We trusted the monitor, and saw why it could mislead us.
 
Ohhhh, ok. For some reason I thought you meant that as his 12 lead was negative for any changes, so you guys were surprised when it turned out something was wrong.
 
I'm sorry to hear about your father. My own father has recently been going through some cardiac issues, and I dread what might be coming down the line for him... Prayers sent your way.
 
Aidey said:
Ohhhh, ok. For some reason I thought you meant that as his 12 lead was negative for any changes, so you guys were surprised when it turned out something was wrong.
Click to expand...

That's the thing- his 12-lead was negative for any changes at all. He literally was EKG-perfect until he coded.

Symptom-wise too, he had intermittent 7-10/10 pain, radiating to the jaw bilaterally, spontaneous onset and resolution. Occasional nausea.

We knew he had a blockage, but going by signs and symptoms, I never would have guessed he was a likely code candidate. When he did go into V-tach, I was really, really surprised.

I miss him- 59 is way too young to die.
 
This is the same thing that happened to my dad in 2010.

Dad had no history, just retired from the navy where he always did well on PT tests. Woke up with left shoulder pain, chest pressure and left hand numbness. Rated it kinda low on the 1-10 scale. Walked into the ER about an hour after it started.

Initial 12 lead was perfect, blood work perfect etc. just the pain.

He went from a perfect sinus to vfib. One shock and he converted back. ER hung lido and he headed to the cath lab where a 100% block was found.

His 12 lead didn't change till after he was in the cath lab and his enzymes never reached the threshold for cardiac event.

Do not depend only on 12 leads- they are a tool- not the final answer. And always keep an index of suspicion up with pain or anginal equivalents.
 
It was an eye-opener- he was the only man I've ever seen walk over to the cardiologist (in his gown and socks, nonetheless) and start BSing with him. He will be missed.

The first time we had a family dinner together, he'd gotten reservations at one of the Mexican places here- nice place. He loved my dog (a little Chihuaha named Papo) and picked him up. He took the dog in with us and ordered him a little steak. He was awesome.

I'm most grateful for the last week we had with him, and that he didn't die on the road.
 
I'm kicking myself for not snagging an EKG printout, but after that Wellen's sign popped up in the thread from nx, I really think it might have been there-but-subtle.
 
Thank you. I reckon it's a somber warning.
 
You must log in or register to reply here.
Back
Top