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Critical case of 26-year-old patient in Dubai raises concerns over undiagnosed hypertension

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Kathierasan Thyagarajan’s life was saved in the nick of time. The man went into CODE BLUE and it took a full 45 minutes of Cardio Pulmonary Resuscitation (CPR) to revive him. Image Credit: Supplied Dubai: The case of a 26-year-old youth who was saved in the nick of time after he suffered a heart attack and collapsed at the entrance of a hospital Emergency Room (ER) in Dubai has raised concerns over undiagnosed hypertension in youngsters on World Hypertension Day today. The man went into CODE BLUE and it took a full 45 minutes of Cardio Pulmonary Resuscitation (CPR) to revive him.

The last thing that Kathierasan Thyagarajan remembers at 7am on April 14,is telling his roommates he was having chest pain and feeling breathless. Next, he was at the ER of the NMC Specialty Hospital, Abu Dhabi where he collapsed at the door. Timely surgery after this attack helped save his life.

Dr Sanjay Rajdev, Consultant Interventional Cardiologist at the hospital, told Gulf News, “Normally if a collapse is unwitnessed, then chances of survival of a patient like this are very slim because brain damage is caused during every minute that is lost. In a case like this where the patient collapses at the hospital ER or is witnessed by friends who can rush him for emergency help, it is possible to revive the patient even after a lapse of some time.”

However, in Thyagarajan’s case despite the CPR that was done, securing the patient’s airway under anaesthesia and providing ventilator support, death seemed imminent as he had no rhythm or pulse for more than 30 minutes.

Dr Sanjay Rajdev

Death stared at us as we frantically continued to provide the CPR, we were drenched in sweat and we kept encouraging one another to do one more cycle, and one more, as he was young and might make it. Forty minutes into the process, the doctors started feeling helpless. Miraculously then, a feeble pulse was detected.

Massive heart attack

An immediate electrocardiogram (EEG) was done and their worst fears were confirmed. The young man, who had suffered a massive heart attack, was rushed to the CATH lab and a swift angioplasty was carried out with the implantation of a single stent.

After that for the next 24 hours, he underwent targeted temperature management, was electively ventilated in the Intensive Care Unit (ICU) and his vital parameters monitored. Fortunately, there were no complications and Thyagarajan, the sole breadwinner of his family, opened his eyes after 24 hours. Over the next few days, he underwent cardiac rehabilitation and was discharged within a week, with comprehensive instructions for further care.

What triggered the heart attack?

On subsequent investigation it was discovered that the patient had undiagnosed hypertension and was taking no medication or precautions which precipitated the massive heart attack.

Dr Rajdev cautioned, “One in four people in the UAE suffer from hypertension which is similar to the prevalence of hypertension worldwide. We have teenagers as young as 14 coming in with hypertension and people in their early twenties complaining of palpitation and throbbing that is later diagnosed as early incidence of hypertension. This is happening because of an underlying congenital heart condition, high sodium content in diet, consumption of processed foods, smoking, lack of exercise and stress. In the last one year, stress levels have gone up and younger people working from home are getting hypertension. But many, especially blue collar workers do not understand their condition is chronic. In the case of Thyagarajan, the ignored case of underlying hypertension was like a time bomb ticking away, waiting to explode,” explained Dr Rajdev.

Untreated hypertension can lead to heart attacks

Dr Rajdev added that young patients who suffer acute coronary syndrome may have traditional risk factors as well a genetic propensity. “Untreated hypertension is associated with higher risk of stroke and myocardial infarction. It’s quite intriguing that this gentleman had no other conventional risk factors other than systemic hypertension. It underlines the importance of regular health checks and once diagnosed with hypertension, to adequately treat it with lifestyle measures and medication if needed,” he cautioned.

How COVID-19 vaccine drive has helped diagnose hypertension cases

Dr Rakesh Sankar, head of the department of internal medicine at NMC Specialty, Al Nahda Dubai, said the practice of checking blood pressure prior to administering the COVID-19 vaccine is a blessing in disguise. “In pre-pandemic times, the diagnosis, prevention and treatment of hypertension was often left unchecked. However, due to the efforts of the health authorities in making blood pressure screening mandatory prior to the COVID-19 vaccination, many undiagnosed cases have come to the forefront. We are now seeing more than 40 per cent patients with hypertension complaints in our hospital. Early diagnosis, medication and lifestyle changes go a long way in managing hypertension and averting serious complications,” he said.

“Every human life is precious and there is no greater joy than the ability to help preserve it. NMC Healthcare is committed to our work in ensuring that quality healthcare, which we believe should be available to every citizen, is effectively delivered when life becomes fragile. I am very grateful to our skilled clinicians in the field for providing this highly specialised care and grateful to the UAE health regulators for trusting our ability to deliver it,” said Michael Brenden Davis, CEO NMC Healthcare.

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