July 16, 2012
Cooling Procedure Saved Pregnant Heart Attack Victim; What Happened to the Baby?
A 33-year-old pregnant woman at 20 weeks collapses while attending a church function and a physician at the scene began receives CPR (cardiopulmonary resuscitation). According to a recent article in the Annals of Emergency Medicine, emergency workers arrive and shock her heart out of a life-threatening irregular heart rhythm and 25 minutes later, it beats in a normal pattern. The patient however, appears to be in a coma which occurs when the brain doesn’t receive enough oxygen. The hospital physicians enter unchartered water and perform a procedure that has rarely been done in pregnant women. They cooled her body temperature to 90 degrees, a procedure known as hypothermia for an hour in an attempt to improve her condition and then slowly rewarmed her body back to its normal temperature in order to save her life. It worked and during the procedure an ultrasound showed the fetus shivering.
Heart conditions during pregnancy are rare, affecting only 1 to 4% of patients. This particularly patient had a condition called cardiomyopathy which is an enlargement of the heart, causes heart failure and is often fatal. It is a disease that hits close to home because it killed my grandmother six months after she delivered my aunt. The heart is considered a pump that helps circulate blood throughout the body and heart failure means the “pump” is not working properly. No one knows exactly why cardiomyopathy occurs but it tends to affect
- women over 30
- African American women and
- women who have several children
Fortunately, the patient had a device implanted 8 days after her heart attack that helped her heart beat in a normal pattern. The patient was discharged home from the hospital after 10 days, returned to work in 4 weeks and then delivered a normal baby boy at 39 weeks who weighed 5 lbs. 15 oz. The baby was evaluated at 1, 2, 3, 6, 12 and 36 months of age and is completely normal.
Although hypothermia has been used as a treatment for heart attack victims since 2005, pregnant women were previously excluded. However as a result of this case, I suspect they won’t be excluded anymore.