Case Review, Patient Management, AMI Cardiogenic Shock
A Story of Significant EF Improvement with Biventricular Impella® Support
Babu Eladasari, MD, BS, FACP, MBBS, presents the case of a 67-year-old Asian male with chest pain and subsequent cardiac arrest. “One of the interesting things about this patient is recovery of the heart from 5% of ejection fraction to 55% ejection fraction, which is normal. Even more interesting, for me,” Dr. Eladasari explains, “is… I am the patient.”
Dr. Eladasari recounts the night of his cardiac arrest. “We were at the temple. I had some chest tightness with mild sweating. So, I got into the car.” He explains that he asked his wife to drive him to the emergency room. She called 911 and the 911 team suggested that she stop the car and do CPR. As it turns out, she happened to stop the car next to the Naperville Fire Station, where several men immediately approached the car to help.
Tony DeMartini, MD, interventional cardiologist at SIU School of Medicine Memorial Medical Center, explains that initially Dr. Eladasari came to the ER having had cardiac arrest and in cardiogenic shock. “He was taken emergently to the cath lab,” Dr. DeMartini recalls, “where he had an Impella CP® placed to help support his heart in pumping blood out to the body.” Angioplasty revealed 90% stenosis in the RCA and LAD. “The right side of his heart decompensated and he had a second device, called an Impella RP®, put in to support that side of the heart. So, then we had both the left and the right side supported.” After 4 days on biventricular support, the Impella RP was removed and the Impella CP was removed on day 5. “After he got the support, I know his discharge ejection fraction was 55%,” Dr. DeMartini reports. “He had gone from severe heart dysfunction to a normal heart function with the support.”
“Thank God for the Impellas,” states Pam, Dr. Eladasari’s wife, “I think they kept him alive.” Dr. Eladasari recounts, “My cardiologist who treated me at Loyola said that ‘if you were taken to any other hospital, they would have certified you dead.’”
“I’m back to normal function,” Dr. Eladasari reports. “Actually, a little better than before. They expected me to be sick for about 6 months, but at the end of 3 months I was back to full-time work, and also teaching. That’s my passion.” Dr. Eladasari is a staff physician and faculty at Loyola University Medical Center. “I’m so grateful for the chance given by the physicians who made a decision to put (in) the Impellas.”
“I just want to pass on this message to my fellow physicians,” Dr. Eladasari concludes. “Patients go through tough times, difficult cases, difficult situations; but never give up hope. There is technology. There’s help. There’s grace of God. Continue to support and do your best.”