01st May 2023, New Delhi: In a rare case, experts at Indraprastha Apollo Hospital remotely managed an 80-year-old man who suffered a heart attack and two episodes of cardiac arrest while being transported in an ambulance en route to Delhi through tele-management. Initially, he was taken to a local hospital in his native city, Varanasi, where a preliminary examination revealed that his heart was operating at only 20% efficiency with severe valve leakage. He was in cardiogenic shock and had to be ventilated. The doctors there gave up hope and in desperation, while his health was deteriorating, his family consulted Dr NN Khanna, Senior Consultant, Cardiology & Vascular Intervention, Indraprastha Apollo Hospitals, New Delhi, who recommended immediate interventional treatment for which the patient had to be transported as soon as possible to Delhi. Considering the delay in transportation by air ambulance due to heavy fog, doctors decided to remotely manage the patient via telemedical guidance for 14 hours, while en route to Delhi. After reaching the hospital he was immediately put on left ventricular support (a device that helps pump blood in a failing heart condition ). This was followed by a complex multi-vessel coronary angioplasty procedure with the aim to pull him out of the cardiogenic shock, fix severe leaking of the mitral valve, and manage pulmonary edema (Fluid accumulation in the lungs because of heart failure).

Dr. NN Khanna, Senior Consultant, Cardiology & Vascular Interventions, Indraprastha Apollo Hospitals, New Delhi, said, “When the patient’s son contacted us from Ireland and explained to us the medical condition of the patient and the doctors in Varanasi had given him absolutely no hope, we immediately took the decision to take the chance and recommended to bring him to Delhi. However, due to unfavorable weather conditions, we had to resort to the utilisation of Telemedicine to monitor and manage the patient throughout the 14-hour-long road journey from Varanasi to New Delhi. Telemedicine monitoring has been an extremely vital tool in extending support to save numerous lives, allowing us to remotely diagnose and treat patients and improving access to care. The patient had a history of multiple episodes of cardiac arrests with only 20% functioning of the heart. However, post a 2-hour long cath procedure for placement of implantable cardioverter-defibrillator and left ventricular support device during complex multi-vessel angioplasty, the patient was discharged and traveled back safely to Varanasi.”

A relative of the patient said “We cannot express enough gratitude towards Dr. Khanna and the entire team at Apollo Hospitals for their unwavering commitment and persistence in saving our father’s life. Despite facing multiple challenges, including severe heart attacks, cardiogenic shock, and difficulties in transfer, Dr. Khanna’s expertise and continued care through telemedicine and complex angioplasty played a crucial role in stabilizing our father’s condition.”

The patient recovered and is visiting the hospital for check-ups.