Passersby kept a man alive until paramedics could arrive and transport him to a hospital within the “golden hour,” after the American traveler experienced a massive heart attack while hiking in Taipei last month, Taipei Medical University Hospital said on Friday.
The man, who preferred to use the pseudonym Atom, suddenly lost consciousness and fell to the ground on Xiangshan (象山), other hikers rushed to check on him and found that his heart had stopped beating, the man and hospital staff told the news conference.
One of the hikers performed cardiopulmonary resuscitation (CPR) on him, while others retrieved a nearby automated external defibrillator (AED).
Photo courtesy of the Taipei Medical University Hospital
When paramedics arrived, they took over resuscitation and rushed Atom, who was determined to be in out-of-hospital cardiac arrest, to nearby Taipei Medical University Hospital.
The emergency medical team performed catheterization and extracorporeal membrane oxygenation (ECMO) on Atom, saving his life.
Atom, who underwent two weeks of treatment following the incident, told the news conference that he was determined to have had a left anterior descending artery occlusion, which is often called a “widow-maker” heart attack due to its high fatality rate of about 88 percent if treatment is delayed.
“I would not be standing here if it were not for all of you,” he said, thanking the passersby who performed CPR and called the paramedics, as well as the paramedics and medical team.
Tsai Hung-wei (蔡鴻維), a doctor who first treated Atom at the emergency room, said the treatment of myocardial infarction is a race against time, and Atom was fortunate that he was found by people who could perform CPR and that an AED cabinet was nearby.
The paramedics were able to use the AED and rush him to the hospital within the “golden hour,” for a smooth transition to catheterization and ECMO, Tsai said, adding that the key to a successful rescue is the seamless transition from emergency pre-hospital treatment to hospital treatment.
As Atom was in cardiogenic shock when he arrived at the hospital, medical staff had to perform critical measures — ECMO to support cardiopulmonary function, then catheterization to remove artery blockage and stent placement — in a short time, said Yang Tsung-lin (楊宗霖), a cardiologist at the hospital.
After being admitted to an intensive care unit, he was placed under therapeutic hypothermia to protect his brain, Yang said, adding that Atom regained consciousness without any lasting neurological damage, and can move around normally.
Chao Chun-chien (趙君傑), director of the hospital’s Department of Emergency and Critical Care Medicine, said that cold temperatures can cause blood vessels to constrict and blood pressure to rise, making the heart work harder, and hiking sometimes requires high myocardial oxygen consumption.
Therefore, if a person has the “three highs” — high levels of blood lipids, blood sugar or blood pressure — is obese or is a smoker, they are more likely to trigger angina pectoris (chest pain caused by reduced blood flow to the heart) or a heart attack from hiking uphill, Chao said.
A study suggested that the risk of heart attacks is highest during the morning, particularly from 4am to 10am, when many hikers like to start their hikes, putting them at higher risk of having a heart attack, he said.
People who have the “three highs” or have been diagnosed with coronary artery disease should consult with a doctor before hiking or mountain climbing in the winter, and should perform warm-up exercises for 10 to 15 minutes before setting out, to prevent a sudden rise in blood pressure, Chao said.
Sudden chest tightness or pressure, cold sweats, shortness of breath and extreme fatigue could be signs of myocardial ischemia — abnormally reduced blood flow in the coronary circulation, he said.
If a hiker experiences those symptoms, they should not try to return on their own, but should immediately stop walking, stay warm and call 119 for help, he added.
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