Resuscitation to Reperfusion: Full Neurological Recovery in a STEMI Patient Undergoing Extended CPR and Rescue PCI at Madinat Zayed Hospital

Mahmoud Sami Mohammed; Eriks Sliders; Shanavaskhan Shamsudeenkutty; Ashraf Goma Alakkad; Mostafa Mahmoud  Elshahat Saleh; Mohamed Abd Elrahman

doi:10.18502/aacc.v12i3.21324

Mahmoud Sami Mohammed ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates.
Eriks Sliders ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates.
Shanavaskhan Shamsudeenkutty Cardiology Department, Al Dhafra Zayed Hospital, United Arab Emirates.
Ashraf Goma Alakkad Internal Medicine Department, Madinat Zayed Hospital, SEHA, United Arab Emirates.
Mostafa Mahmoud Elshahat Saleh ICU Department, Madinat Zayed Hospital, AlDhafra Western Region, SEHA, United Arab Emirates.
Mohamed Abd Elrahman Internal Medicine Department, CMO Sila Hospital, Abu Dhabi, United Arab Emirates.

DOI: https://doi.org/10.18502/aacc.v12i3.21324

Keywords: STEMI; Cardiac arrest; Rescue PCI; Thrombolysis failure; Critical care

Abstract

Acute ST-segment elevation myocardial infarction (STEMI) complicated by cardiac arrest poses a significant clinical challenge, particularly in resource-constrained environments lacking immediate access to percutaneous coronary intervention (PCI). We present a case of a 37-year-old male with anterior STEMI who experienced prolonged ventricular fibrillation cardiac arrest. After 20 minutes of high-quality CPR and failed thrombolysis at a rural hospital, he was quickly moved 250 km to a center that could do PCI. An emergency coronary angiogram showed that the proximal left anterior descending artery was completely blocked. Thrombus aspiration and stenting were used to successfully treat the blockage. Full neurological recovery was possible because of thorough intensive care that included early antibiotics for aspiration pneumonia, careful management of hemodynamics, and rehabilitation by a team of professionals. The patient was released from the hospital with stable hemodynamics and better left ventricular function. At the two-week follow-up, they still had no symptoms. This case emphasizes the necessity of well-structured regional care networks, compliance with advanced cardiac resuscitation protocols, prompt identification of thromboembolic failure, and swift referral for coronary intervention to attain positive treatment outcomes for patients with STEMI and cardiac arrest. It also shows how important it is to have systems that make it easy for hospitals to work together quickly, which can save lives and help people recover from neurological problems, even in remote areas.