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3. If she had the heart attack FIRST and then stopped breathing. As most people understand, a person who's heart is not beating is probably not breathing either. Almost all anesthesia drops the blood pressure at least a little. If Joan's heart was in bad shape, that could be enough to trigger a heart attack. But if her heart was that bad, why didn't they know about it? It is possible that tests never showed how bad her heart really was, or that she never had the proper tests in the first place. Or, something was missed or ignored. I don't know. If they knew about it, they clearly should have taken steps to avoid this. If they didn't, it may not be anyone's fault other than the questionable decision of doing it at an outpatient center instead of in a hospital.
Of course that's always true. But she's been very open to the public that she's had a heart arrhythmia as early as 1985. She always discussed it and how she was scared to death of medical procedures because of it.
Her cardiologists allegedly cleared her for the procedure.
As long as we're hypothesizing, my instinct is she'd never go under without having been current with her cardio docs. Then again, maybe she's declined extensive cardio exams.
But I am shocked that she didn't have the scope done in a regular hospital, too. It seems her cardiologist fell down on the job IMO.
My mother's cardiologist actually APPROVED her to go off coumadin a few short months after a 5 graft bypass. I was FURIOUS with them.
She had a TINY malignant breast lump that the breast specialist said was NOT A PROBLEM at her age. But she nagged and nagged and wouldn't let it go. So he agreed to remove it as long as her cardio gave a release.
So against my advise, went off the Coumadin and had a stroke 3 days later. Rotted in a nursing home for a year after. All for nothing.
So you're right. You never know with people what the real situation is. Until you know.
Also, dogs ALWAYS have problems with anesthesia not just humans. And my dog's megaesophagus was 100x worse after being scoped than before.
Just like anesthesia, scopes are NOT just some little unserious deal.
3. If she had the heart attack FIRST and then stopped breathing. As most people understand, a person who's heart is not beating is probably not breathing either. Almost all anesthesia drops the blood pressure at least a little. If Joan's heart was in bad shape, that could be enough to trigger a heart attack. But if her heart was that bad, why didn't they know about it? It is possible that tests never showed how bad her heart really was, or that she never had the proper tests in the first place. Or, something was missed or ignored. I don't know. If they knew about it, they clearly should have taken steps to avoid this. If they didn't, it may not be anyone's fault other than the questionable decision of doing it at an outpatient center instead of in a hospital.
Wouldn't the lower BP be better and be less likely to cause a heart attack? (my doctors tells me low BP is fab so going from that her risk would be even lower)
As someone with an arrhythmia and female I know how hard it is for a cardio to take it serious. I assume though if you are rich and famous they are more likely to do the tests and try harder than for someone not insured.
I wonder if she was talking about mitral valve prolapse syndrome. Since she said it's a "female" thing. The interview was some time ago when I know MVP was more commonly diagnosed, and is more common in women. (Now with more data doctors claim small amounts of prolapse are "normal" and not to worry about) Just totally describes what she talked about and the thud which is lively a PVC.
Extreme stress, long days with no sleep and lots of work...... she walked the stairs!!! I mean this woman had stamina!
Wouldn't a heart attack be from a blockage and they didn't find that in the autopsy? So if it was her heart is was an arrhythmia and there is no way to detect that (as far as I know)
Also wouldn't you have a change before the MI on the EKG? I don't know, some warning so you could try to prevent it?
Wouldn't a heart attack be from a blockage and they didn't find that in the autopsy?
Heart attack could be a result of apnea - stop breathing:
Quote:
Originally Posted by AnesthesiaMD
If someone has partially or fully blocked arteries in their heart, and the oxygen in their blood goes too low (i.e. if they stop breathing for a short period of time), they can have a heart attack.
****
Quote:
Originally Posted by BritinUSA
Also wouldn't you have a change before the MI on the EKG? I don't know, some warning so you could try to prevent it?
Not necessarily.
Quote:
Originally Posted by AnesthesiaMD
If there is evidence of this on the ekg, the anesthesiologist will cancel the procedure before it even starts, until a further workup is done by a cardiologist.
Problem is, often the ekg is normal because the body isn't under stress when the ekg is being done.
Wouldn't the lower BP be better and be less likely to cause a heart attack? (my doctors tells me low BP is fab so going from that her risk would be even lower)
As someone with an arrhythmia and female I know how hard it is for a cardio to take it serious. I assume though if you are rich and famous they are more likely to do the tests and try harder than for someone not insured.
I wonder if she was talking about mitral valve prolapse syndrome. Since she said it's a "female" thing. The interview was some time ago when I know MVP was more commonly diagnosed, and is more common in women. (Now with more data doctors claim small amounts of prolapse are "normal" and not to worry about) Just totally describes what she talked about and the thud which is lively a PVC.
Extreme stress, long days with no sleep and lots of work...... she walked the stairs!!! I mean this woman had stamina!
Wouldn't a heart attack be from a blockage and they didn't find that in the autopsy? So if it was her heart is was an arrhythmia and there is no way to detect that (as far as I know)
Also wouldn't you have a change before the MI on the EKG? I don't know, some warning so you could try to prevent it?
Lowering the blood pressure too much or too quickly can be just as harmful as high blood pressure. While having high blood pressure makes the heart work too hard, lowering the blood pressure too much deprives it of oxygen. Going from a systolic of 150 down to 110 is ok. Going from a systolic of 110 to 70 may not be ok.
I am going to be brief in answering your questions here because I don't want to thread jack this thread. The whole reason we monitor the heart during surgery is so we can pick up a heart attack before it happens. Sometimes it happens too quickly. The pre OP EKG can be normal, as I said earlier because the heart is not under stress at the time they do the EKG. If I really suspect something, I order a stress test
A heart attack can be cause by a blockage or by vasospasm. A blockage can be found in an autopsy, vasospasm may not. I don't know what they found. Was it in the news? I have been working this weekend so I am a little behind.
Arrhythmias? Some can be dangerous and some are benign. I don't know what kind she had. If she had a dangerous one, I would expect her to have a pacemaker/defibrillator implant. Most MVP is benign.
Heart attack could be a result of apnea - stop breathing:
Ever hold your breath? Your pulse goes up, you throw ectopic beats.
but hey if you are on a monitor you'd catch that, and the lower resp rate, the machine would bing bing bing
I guess if the report is they called 911 for someone who "stopped breathing for we don't know how long"
I can't see how they were on a monitor.
Devils advocate, you are on a monitor, have oxygen and full proper treatment at the centre, transfer to the hospital, there should be no time without oxygen right? They got her heart back, no reason why she didn't have o2 the whole time.....unless she wasn't on a monitor
Oh and the comment about the EKG being normal at the time telling you nothing, totally correct! But she had a diagnosis of some sort and I'm sure had more than a random EKG.
A heart attack can be cause by a blockage or by vasospasm. A blockage can be found in an autopsy, vasospasm may not. I don't know what they found. Was it in the news? I have been working this weekend so I am a little behind.
Arrhythmias? Some can be dangerous and some are benign. I don't know what kind she had. If she had a dangerous one, I would expect her to have a pacemaker/defibrillator implant. Most MVP is benign.
They claim they found nothing wrong with her heart but not sure if the autopsy report is public and if there is more to it. Of course if it was an arrhythmia we'd never know
Yeah I can't see she had anything too serious and led such an active lifestyle at her age. When she said it was a female thing that totally sounded MVP to me, which I know changed over the years from when I was first told I had it to now when they say it's normal. Women seem to get more (or notice more) of the flips flops and thuds she spoke of.
I guess we all hope that if we are in a top notch centre to have something minor done and something goes wrong, our heart goes funny, our BP drops, whatever that the doctors there can fix it.
So sad, and seeing the sadness in her grandson's eyes today made me cry.
Ever hold your breath? Your pulse goes up, you throw ectopic beats.
but hey if you are on a monitor you'd catch that, and the lower resp rate, the machine would bing bing bing
I guess if the report is they called 911 for someone who "stopped breathing for we don't know how long"
I can't see how they were on a monitor.
Devils advocate, you are on a monitor, have oxygen and full proper treatment at the centre, transfer to the hospital, there should be no time without oxygen right? They got her heart back, no reason why she didn't have o2 the whole time.....unless she wasn't on a monitor
Oh and the comment about the EKG being normal at the time telling you nothing, totally correct! But she had a diagnosis of some sort and I'm sure had more than a random EKG.
Did you read my post about laryngospasm? It is very possible they picked up that she was not breathing, but still could not ventilate her until it was too late.
Also, there are several ways to monitor breathing. The most sensitive way is with a CO2 (carbon dioxide) monitor. You need a fairly recent portable monitor to have this capability, and even so, some of my colleagues still don't do it. We have been doing it in the REAL operating room for many years, so now that the new portable monitors can do it in the endo suite, why not do it? I don't get it. They still use the monitor that detects chest movement (very unreliable) and the pulse oximetry (picks up later than co2). But also, there are still a lot of endo centers that don't have the new monitors.
Did you read my post about laryngospasm? It is very possible they picked up that she was not breathing, but still could not ventilate her until it was too late.
Also, there are several ways to monitor breathing. The most sensitive way is with a CO2 (carbon dioxide) monitor. You need a fairly recent portable monitor to have this capability, and even so, some of my colleagues still don't do it. We have been doing it in the REAL operating room for many years, so now that the new portable monitors can do it in the endo suite, why not do it? I don't get it. They still use the monitor that detects chest movement (very unreliable) and the pulse oximetry (picks up later than co2). But also, there are still a lot of endo centers that don't have the new monitors.
Yep, I saw, and that i possible. I was replying to the person talking about apnoea though.
I don't know, the pulse oximetry is not that slow to pick up a drop is it? I have one and I know it's quite quick to show apnoea when I have them.
Still top of the line medical centre.... should have something more than a pulse oximetry
Yep, I saw, and that i possible. I was replying to the person talking about apnoea though.
I don't know, the pulse oximetry is not that slow to pick up a drop is it? I have one and I know it's quite quick to show apnoea when I have them.
Still top of the line medical centre.... should have something more than a pulse oximetry
It can take one or two minutes between the time the patient stops breathing, and the time the oxygen saturation in the blood starts to fall. That is still a whole lot better than the old way before o2 sat, when you only knew after the patient's lips turn blue.
But the CO2 monitor lets you know the very second the patient stops breathing.
Well, one thing I've learned for sure from this thread - no clinic/surgery center for me if I need anesthesia/sedation - for even a minor procedure.
One other thing I heard this morning. Joan had checked into Yorkville at 8:30 a.m. and by 9:35 a.m. they were calling 911.
Waaaay too early in the day, imho.
When I was dealing with a broken leg seven years ago at age 65, one morning around 7 or 8, I managed to scoot down the steps, went to kitchen on crutches to start breakfast, head feeling really heavy - and promptly PASSED OUT. When my eyes opened, I was on kitchen floor. Fortunately, not hurt. Leads me to believe, if I had sedation at 9 a.m., I'd be dead, too. Have always been at my best in the mid-late afternoons. Only becomes more so, the older I get.
QVC women wearing Joan's broaches, pearls, jackets, earrings.
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