Mr. L.V.H (32 years old, Binh Trung ward, Ho Chi Minh City), as usual, played badminton with a few colleagues at a practice yard in An Khanh ward, Ho Chi Minh City. After playing badminton for about 30 minutes, Mr. H. suddenly felt nervous, dizzy, short of breath and severe pain in the chest area and quickly lost consciousness. Mr. H. was immediately taken to the nearest hospital by his badminton friends.
When arriving at the hospital, Mr. H. fainted and lost consciousness, stopped circulating. Immediately, Mr. H. was diagnosed with ventricular arrhythmia, had his heart and lungs revived, and a red alert was activated inter-hospitalally with Gia Dinh People's Hospital.
After 15 minutes, Mr. H. was taken to the Emergency Department, Gia Dinh People's Hospital, with the preparation of the ECMO (extracorporeal membrane oxydation) team of the Cardiovascular Intensive Care Unit. Immediately upon admission, Mr. H. was both resuscitated for ventricular dysfunction and received emergency V-A ECMO intervention (extracorporeal membrane oxydation by arterial-venous method).
After stabilizing circulation, Mr. H. underwent a full-body CT scan to rule out common causes of sudden cardiac death such as acute myocardial infarction, pulmonary artery embolism or acute aortic disease.
In just 48 hours of resuscitation after a deep cardiac arrest with V-A ECMO, body temperature control, high-dose corticosteroid use due to suspected viral acute myocarditis and continuous blood filtration, Mr. H. was completely awake, no longer had ventricular dysfunction, heart function recovered and V-A ECMO stopped.
After 7 days of hospitalization, Mr. H.'s functional condition is now almost completely stable and he can be discharged from the hospital. The results of cardiac resonance imaging afterwards confirmed that Mr. H. had acute inflammation in the heart muscle and pericardium.
Happy after recovering, Mr. H. shared: "When playing sports, if signs of fatigue or pain appear, you should stop and go to the hospital for examination, do not try too hard and do not be subjective about your health.
Master - Doctor Vo Van Trang, Department of Cardiovascular Intensive Care, Gia Dinh People's Hospital said: "Acute myocarditis caused by viruses often appears a lot in cold weather months or rainy seasons in Vietnam, with common symptoms such as flu, gastroenteritis... causing patients, especially young people, to be subjective.
In addition to respiratory or digestive symptoms, patients with acute myocarditis also have cardiovascular symptoms such as chest pain (>80% of patients), shortness of breath (20 - 50% of patients), palpitations... A small number of patients with acute myocarditis can develop acute myocarditis with arrhythmia, low blood pressure due to weak myocardial contractions and leading to sudden death if not detected and treated promptly. Most acute myocarditis can recover quickly after 1 week when promptly and appropriately intervened to support mechanical circulation.
However, Master - Doctor Nguyen Thanh Thao, Department of Cardiovascular Intensive Care, Gia Dinh People's Hospital, said that not every patient with acute myocarditis caused by a virus is as lucky as the case of Mr. H. when sudden death was detected and quickly rescued thanks to the harmonious inter-hospital coordination.
With the characteristic of inflammation spreading over the heart muscle through cardiac resonance imaging, patients need to be closely monitored and screened for gene mutations of heart muscle disease and heart muscle biopsy if persistent myocarditis progresses. Patients also need to limit effort in the first 3 months, to avoid the risk of sudden death and recurrence of arrhythmia.
