Doctors at Vinmec Times City International Hospital raced against time to save the life of a 62-year-old patient with a heart rupture who experienced two cardiac arrests. Typically, most similar cases result in death if not surgically treated promptly, and even with surgery, only 50% of them survive, often with neurological sequelae. In this particular case, the patient has a miraculously complete recovery.
Patient D.T.N (62 years old) was admitted to the hospital with shortness of breath and chest pain. The patient was diagnosed with acute myocardial infarction and was scheduled for a standard coronary intervention.
During the preparation for the coronary intervention, the patient’s condition rapidly deteriorated, leading to cardiac arrest (heart stopped beating). Immediately, Vinmec Times City International Hospital activated CODE BLUE – an alert code for cardiac arrest, mobilizing all trained and responsible team members to provide emergency care. The medical team, led by an intensive care specialist, performed cardiopulmonary resuscitation, successfully restored the patient’s heart rhythm and maintained stable blood pressure within less than 5 minutes of the cardiac arrest.
After the heart resumed beating, specialists conducted a consultation and determined that the cause was a heart wall rupture (ventricular rupture) leading to blood leakage into the pericardial sac, causing acute cardiac compression. Left ventricular rupture following acute myocardial infarction is a severe mechanical complication, accounting for approximately 1% of cases of acute myocardial infarction. The cause is the necrosis of the heart muscle leading to a rupture of the heart wall, resulting in blood leaking into the pericardial sac, and ineffective squeezing of the heart, leading to cardiac arrest. Emergency surgery was immediately indicated to relieve cardiac compression and address the ruptured wall. Delaying the surgery would have resulted in the patient’s death.
During the operation, the patient experienced a second cardiac arrest, intensifying the race against time for the surgical team. In medical terms, this is a critical cardiac emergency that requires immediate intervention as blood is leaking outside the heart and compressing it, causing inadequate blood supply to the brain. The surgical team from the Cardiovascular Center at Vinmec Times City International Hospital, under the coordination of Dr. Dang Quang Huy – Deputy Director of the Center, promptly performed a sternotomy to relieve the cardiac compression, followed by patching the ventricular defect.
“To successfully rescue critical cases like this, the most important factor is time. The operating room and surgical team must be ready immediately because the patient’s life is being counted in minutes and seconds. The procedures must be fast and precise to have a chance of successful rescue,” shared Dr. Dang Quang Huy.
Finally, the nearly four-hour surgery was successfully completed. After one day of surgery, the patient regained consciousness, was weaned off the ventilator, had good cardiac function, and was monitored in the intensive care unit. Currently, after less than a week, the patient has been transferred to a regular ward and is able to move and engage in activities as before the operation. Remarkably, the patient has no neurological sequelae despite experiencing resuscitation for two cardiac arrests.
According to global medical literature, myocardial infarction complications often have a high mortality rate if not surgically treated promptly. Even with surgery, only about 50% of patients are saved, and there are often neurological sequelae due to cerebral ischemia. To have a chance of survival, when myocardial infarction complications are detected, patients need to be promptly referred to hospitals with the capability of emergency care and quick surgical intervention, along with a team of experienced cardiovascular surgeons to handle complex cardiac issues.
Furthermore, receiving timely cardiopulmonary resuscitation (CPR) during the golden hour is also crucial in increasing the chances of survival and limiting neurological complications for the patient. “CODE BLUE” is one of the standardized emergency codes implemented by Vinmec hospitals in the process of rescuing patients who experience sudden cardiac arrest, respiratory arrest, or sudden deterioration threatening their lives.
The Vinmec healthcare system has implemented the Code Blue system throughout its entire network since the hospitals became operational. There are two dedicated Code Blue teams on duty during working hours and at night to ensure 24/7 capacity for resuscitating patients with cardiac arrest. In recent years, the CODE BLUE protocol at Vinmec has been developed according to JCI (Joint Commission InternaCODEBLUE was executed effectively at Vinmectional) standards. Specifically, all members of the CODE BLUE team are well-trained and certified with ACLS (Advanced Cardiovascular Life Support) and PALS (Pediatric Advanced Life Support) certificates from the American Heart Association (AHA), which are renewed every two years. The application of emergency codes in the hospital admission and management process, both in general emergency cases and particularly in severe and complex emergencies, ensures that the emergency team will appear in the shortest possible time and in the right place to provide early assistance to patients.
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