Heart attack & 25 minuet cardiac arrest

[Husband4life]

My husband (49) had an inferior stemi out of the blue at the end of October. His right coronary artery was completely blocked, so he had an emergency stent fitted in hospital. Shortly after this he went into cardiac arrest on the Coronary Care Unit. He was shocked several times over a period of 25 minutes before they could stabilise him. He was then in an induced coma with some hypothermic treatment for 8 days. It should have been less, but he got aspiration pneumonia and they couldn’t stabilise his blood pressure and oxygen levels when they tried to bring him round. Eventually did a tracheotomy which was successful and spent another week in ICU and came off the ventilator. Had some mild psychosis in the first few days whe he came round. He only spent a short time on the normal ward afterwards & came home with a zimaframe, but is now doing well considering - pottering around the house unaided, etc. He has however lost a lot of weight, has a poor appetite and is very weak and sometimes breathless and nauseous. The district nurse who has been sorting his tracheotomy dressing suggested protein shakes (he had these in hospital for a few days) which have now been prescribed, but it is muscle he hasn’t lost that won’t be replaced whilsthe is so inactive. The doctors have said his heart is only mildly damaged (mild systolic impairment) and it is pumping well, but he is on amlodipine, bisoprolol & ramipril, as well as all the usual - aspirin, ticagrelor, atorvastatin. My questions are: 1) is it normal to be on 3 tablets for blood pressure, or is this for heart failure & will he make a full recovery? 2) The cardiac nurse has said he isn’t ready for rehab and the doctor has said he will have to seek advise from the cardiac nurse as to when he can drive because of his weakness. How long is his recovery likely to take and is it slow because of the heart attack, or other compllcations? 3) His only other risk factor was raised cholesterol that he was trying to manage with diet and his other arteries don’t need stents. Does this mean he is likely to be prone to unstable plaques rather than artherosis?

[Prada47]

Hi pleased to meet you,

You have been on one heck of a journey. On the positive side your Husband is Home and appears to be getting the Care he needs. As far as medication goes it's difficult to say a lot depends on any ongoing symptoms. I take Candesartan/Eplerenone and Bisoprolol which to a certain extent are all helping Blood Pressure and also helping with the control of my Pulse . For Clot prevention I take a 75mg Aspirin and a 75mg Clopidrogel. Medication seems to follow a very well established route so trust your in good hands.

Best Wishes

[Husband4life in reply to Prada47]

Glad to hear medication seems fairly standard.

[Hidden]

Hi,

What a terrible time you have both had.

I can’t answer most of your questions but can offer some insight re the infection and ITU stay. I am an ex ITU nurse and there is very poor understanding of the burdens of prolonged ventilation and infection. It can take many months to get back to anything approaching normal.

Although it may be too soon for cardiac rehab has your husband been referred for physio and Occupational therapy to help his recovery as they can offer practical advice re pacing etc?

[Husband4life]

Saw physio in hospital, due to see one at local hospital 14th dec. Glad to hear some of the fatigue is probably due to the icu stay.

[Nathan53]

Sorry to hear about the awful experience you have both had. Sometimes a combination of blood pressure meds is needed and more effective for some people than just one. Although bisoprolol may have a bp lowering effect I was told the main reason for prescribing it was to lower and strengthen the heart rate. I wouldn't have thought heart failure was not present in view of your other comments and the fact that heart is pumping well but you may benefit from calling the BHF Nurses for clarification. Many people can have a lengthy recovery period after pneumonia of any sort and your husband has also had other problems. A few years ago I nursed my Mother after she came out of hospital due to bacterial pneumonia - she was in her 80's was in ITU for 10 days and lost 2 stone. Her appetite was virtually non existent. The protein shakes are very good if solid food is not tolerated but I found it was a balancing act. Sometimes consuming one of the drinks puts people off having other food later in the day. I found soups and very small portions of food served on a large plate can be beneficial as psychologically it makes the portion of food look smaller and doesn't put the person off. Eating little and often and whatever the person is drawn to. It was a struggle getting my Mother to eat anything then one day me and partner were eating a selection of M&S Chinese food and she stared over at our plates and asked for some - it was a turning point and she ate most of my serving to my relief. The body often knows best. Sorry for such a long reply but hope some of it help. Best wishes you will get there

[Nathan53]

Forgot to say some of the meds - though essential - can cause fatigue which in your husband case may be more extreme if he is not eating much at the moment and not very active. I am sure as he gains strength a more rapid improvement may happen

[Husband4life]

Thanks, that’s helpful

[Karenpr]

My husband had a cardiac arrest 18 months ago and was in an induced coma, suffered pneumonia. Is/was also on the same blood pressure pills. the Tigacelor stops after a year. The blood pressure pills are needed to help the heart recover our GP has reduced the dosage on the Bisoprolol, as husbands resting heart rate was low. The tiredness is normal after the CA and pneumonia and the stay in hospital. Lack of appetite is also normal. All of these will improve with time. My husband still has an afternoon nap (bless). Good luck on your journey towards recovery and take care of yourself.

[Husband4life in reply to Karenpr]

Good to hear it’s all normal for the circumstances

[Neekey]

Sorry to hear your story, however, the good news is he survived. The weight loss is normal, the low heart rate is normal as the tabs are doing their job, and yes the medication is a necessity to keep heart rate and BP stable. As for the future it's up to him. The cardiac Nurse will tell him when the rehab starts and what exercise to do, very short walks initially. The food intake is really important. Keep the saturated fats away, eat a more healthy diet, keep off pastry, cakes, biscuits, this is a new life Fir him now, the mindset has to change, a healthy food change increased exercise and no sitting in chair all day. He may well get tearful but that's normal. Check food labeling when food shopping. There is light at the end if the tunnel, his muscle can be rebuilt. Good luck.

[Husband4life in reply to Neekey]

Thanks

[jimmyq]

In answer to your questions:

1) Yes, I was on 4: Atorvastatin, Bisoprolol, Clopidogrel, Indapamide. I am now off the Atorvastatin (got my cholesterol down) and the Indapamide (wasn't doing anything).

2) His recovery will take as long as it takes, probably months, perhaps years. Keep in touch with his cardiac nurse.

3) What kind of diet was he following to manage his cholesterol?

You should discuss your concerns with his doctor and/or call the BHF Heart Helpline on 0300 330 3311 and talk to a cardiac nurse about it.

[Husband4life]

He was eating less pastries,etc but still had a sweet tooth, Benecol, not much red meat, using olive oil for cooking, more fruit, high fibre cereal although not a big veg eater though

[jimmyq in reply to Husband4life]

I recommend that you watch the film "Forks Over Knives". It is on Netflix and YouTube. It is about global medical research, including a massive study of 800,000 Chinese people. You might find it helpful, I did. It will show you that you can clear out your arteries. In the film, there is a bloke with 27 diseases. After 6 months on a WFPB diet he was down to 1.

[Husband4life in reply to jimmyq]

I’ll watch it tonight, Paul is so tired today he’ll be in bed by 8. I’ll be twiddling my thumbs, so it’ll be good to have something to watch.

[jimmyq in reply to Husband4life]

I hope it inspires you.

[Nathan53]

I had a healthy Mediterranean type diet BUT also liked cakes and biscuits for snacks. I could eat 4 or 5 choc digestives and a glass of milk in-between meals. After a heart attack in April I kept with my usual diet but stopped all biscuits and bought cakes and pastries which contain trans fats which are difficult for the body to process. If I need to snack I have a small handful of walnuts or almonds or piece of fruit and have come to really enjoy. I stopped alcohol as I found it made me sleepy with tablet regime. Ihave lost a stone in weight and eat filling meals. If I accept a biscuits maybe when visiting someone I actually don't enjoy. If either of you are budding or accomplished bakers treat yourself to a homemade cake made with olive oil rather than butter or margerine. There are some lovely recipes on this site just search on 'cakes' or healthy meals. If you would normally use sugar in a recipe try an artificial sweetener like truvia which is plant based. At the moment I suggest your husband eats what he wants (within reason) just until he builds up then focus more strictly on healthy eating.

[Husband4life in reply to Nathan53]

Thanks for the tips, we both like cooking, Paul bakery goods more than me. I’ll check out the recipe ideas & my dad has an old All Bran cake recipe that is fat free that I can ask him for. If you’re interested - I’ll pass in the recipe.