Case study: Acute Kidney Injury in a case of Myocardial Infarction

This Patient Presented with

Sever chest pain. |-1 ½ hr. Profuse sweating

Seen by Cardiologist Dr. Ravindra Sangolkar in his OPD having extensive anterior wall M. I. So without wasting time he gave loading dose (T. Ecosprin 325mg, T.Brillianta 180mg, T. Rozat 40rr mg) & shifted in Synergy Multispecility Hospital.

As soon as Patient arrived in hospital patient having cardiac arrest & he collapsed.

- Immediate CPR Started dc of 200j.

- ECG rhythm assessed- had ventricular fibrillation (one of the fatal heart rhythms)

- Immediate D.C. of delivered fIb CPR continued

- Around 5 cycles of CPR & 3 D.C. given (Shock) Patient reverted with sinus rhythm & spontaneous breathing

- CPR stopped & with all emergency drugs (Inj noradrenalin drip Inj cardaron drip etc) Patient shifted to Cath lab for CAG & for rescue PTCA (Angioplasty)

- CAG revealed proximal LAD total occlusion (1007 Stenisis)

- So, in no time immediate stenting to LAD done (Angioplasty) by Dr. Ravindra sangolkar & re-opened LAD.

- During procedure patient also had ventricular tachycardia episodes – received emergency drugs & 3 D.C. (shocks) of 200J.With successful PTCA to LAD Patient was shifted to CCU & stabilized.

- But war was not over yet. 2D echo revealed left ventricular blood clot & with patient was landed in Acute kidney injury with low Urine output & raised RFT’s (T.B.Urea & Sr. Creat) So accordingly, treatment Regime modified with expert opinion of Dr. Bipin Munjappa (Nephrologist) & continued treatment in cardiac ICU.

- In these types of Cases mortality risk is supposed to be very high but timely management & expert consultation & Excellent cardiac ICU care patient was rescued.

- Around 10 days of ICU care & excellent management patient was discharged in stable condition with decreased RFT’s (L B. Urea & Sr. Creat Values) No Dialysis was required to the patient.

- Finally, it was Patient smile on discharge is the sign of satisfaction for all the Synergy Multispeciality Hospital ICU team.

- The patient is following with Dr. Ravindra Sangolakar & his renul function was improving.