Hanging By a Thread
String of expert care saves Harleysville grandfather after sudden cardiac arrest
Bob Klein, 70, had just completed his routine treadmill workout at the YMCA when he suddenly collapsed in February 2012. He lost consciousness when the electrical system to his heart had suddenly gone haywire, triggering a dangerously fast heart rhythm. Within seconds, Bob’s heart stopped beating, preventing blood flow to the rest of his body.
Bob had experienced a sudden cardiac arrest (SCA)—a leading cause of death in the United States. He, however, would be one of lucky survivors. Fortunately, from the moment he hit the ground, Bob received the best possible cardiac care. The threads of care that saved his life created the safety net for his survival. From immediate CPR, to emergency medical services, to the Abington Health—Lansdale Hospital Emergency Department, to specialty cardiac care at Abington Memorial Hospital, to cardiac rehabilitation—each area of medical expertise was adeptly woven into the next.
Bob’s heart rhythm disorder—ventricular fibrillation (VF)—results when the lower chambers of the heart beat rapidly or quiver and the heart suddenly stops beating. “Without emergency help, SCA leads to death within minutes,” says Andrew Ball, MD, assistant chair, Emergency Medicine, Lansdale Hospital and Abington Memorial Hospital. The only effective treatment for SCA is defibrillation, which shocks the heart back into normal rhythm. Sadly, of those who experience sudden SCA, American Heart Association statistics show that less than five percent make it to the hospital alive.
When Bystanders Become Lifesavers
Some might say that when it came to surviving sudden cardiac arrest, Bob was in the right place at the right time. At the YMCA, vigilant staff members dashed to his aid. A fitness instructor called 9-1-1, while the aquatic director worked to jump start Bob’s heart. Having been trained in the use of an automatic external defibrillator (AED), the aquatic director grabbed the portable, computer-based device and shocked Bob’s heart back into normal rhythm. “Because immediate defibrillation has proven to be life-saving, many public places like the YMCA, shopping malls, airports, schools, and hotels, now keep AEDs on hand,” says Dr. Ball. According to the American Heart Association, in some cities with public access defibrillation, when bystanders provide immediate CPR and the first shock is delivered within five minutes, survival rates from VF sudden cardiac arrest range from 48 to 74 percent.
Exceptional Emergency Cardiac Care
Within minutes of the 9-1-1 call, emergency medical technicians had reached the scene and rushed Bob to the Emergency Department (ED) at Lansdale Hospital. Upon arrival, Bob had a pulse, but his breathing was irregular and he remained unconscious. To stabilize Bob’s heart rhythm, the ED team, trained in advanced life support, administered anti-arrhythmic medications. To help him breathe, they placed a tube in his airway to be secured to a ventilator.
When Bob’s heart had stopped pumping, his brain was without nutrient-rich oxygen for a few minutes and he became unconscious. In order to minimize brain damage, the emergency medicine physician ordered therapeutic hypothermia. The ER team initiated this advanced treatment to cool Bob’s body in a controlled way, with ice packs and chilled saline solution, which they administered through a vein in Bob’s arm.
“Once Bob was stable, the ED nurse placed a single phone call to Abington Memorial Hospital, which set the wheels in motion for his speedy, safe transfer by helicopter,” explains Mary Whelan, RN, MSN, CEN, director of Emergency Services, Lansdale Hospital. At AMH, an interventional cardiologist would provide the additional specialty cardiac care Bob required.
Advanced Cardiac Care at Its Best
The medical team at Abington Memorial Hospital’s Cardiac Care Unit (CCU), expertly trained in therapeutic hypothermia, continued Bob’s treatment. They applied pads of circulating chilled water to his thighs and chest. The CCU staff monitored Bob carefully during the ensuing two days, and then began the gradual, controlled, rewarming process. They wouldn’t know if the cooling had worked to prevent brain damage until he was awake and alert. For four weeks, Bob remained comatose on life support, under the constant, capable care of the CCU staff. His wife, Lynn, rarely left his side.
When Bob finally emerged from his coma, showing very few signs of disability, the Abington Hospital staff nicknamed him Miracle Man. Before being discharged from the hospital, Bob would have to undergo one final procedure to help control the VF that could stop his heart again. During a minor surgical procedure, electrophysiologist Patrick Aquilina, MD, placed a dual-chamber, implantable cardioverter defibrillator (ICD) inside Bob’s chest to continually monitor his heart rhythm. “If ventricular tachycardia or ventricular fibrillation occur, the ICD will be able to restore normal rhythm,” says Dr. Aquilina, who specializes in the diagnosis and treatment of heart rhythm disorders.
Working Toward Recovery
After hospital discharge, Bob worked hard to increase his strength and endurance during outpatient cardiac rehabilitation sessions three times a week at Lansdale Hospital. “I’m forever grateful to the doctors and nurses at every level of care at both Lansdale and Abington Hospitals,” says Bob. “Thanks to them, and the prayers of my family and friends, I’m on this side of the grass,” he jokes.
Today, Bob’s journey has come full circle. He’s back at the YMCA, exercising in the company of other fitness-focused folks. As a semi-retired adjunct professor of organizational ethics and human resources management at Philadelphia University, Bob is no stranger to ambition and determination. They are the traits that keep him motivated to maintain a healthy lifestyle. These traits also prove useful during Bob’s daily routine, when he and Lynn care for two young grandchildren while their mom is at work. “Keeping up with the kids is a workout in and of itself,” says Bob.
If you experience sudden chest pain or other cardiac symptoms, call 9-1-1 and get the nearest emergency department without delay.