83-Year-Old Female Patient successfully recovers from Acute Heart Failure at Aster Hospital, Al Qusais

• Most deaths related to myocardial infarction occur in patients older than 65 years of age.^[1]
• In UAE, cardiovascular diseases (CVDs) are the leading cause of mortality, with premature coronary heart diseases (CHDs) occurring about 10-15 years earlier than in individuals from western countries.[2]

Dubai, 13^th December 2023

Aster Hospital, Al Qusais recently showcased a successful management of a complex cardiovascular case in an 83-year-old female patient suffering from acute heart failure secondary to accelerated hypertension, acute coronary syndrome-non-ST-segment elevation myocardial infarction (ACS-NSTEMI), lower respiratory tract infection (LRTI) and type 2 diabetes mellitus (T2DM). Dr. Anil Prahalada Rao Kumar, Interventional Cardiology Specialist at Aster Hospital, Al Qusais led the multidisciplinary team in treating this challenging case, demonstrating exceptional clinical expertise and innovation in geriatric cardiac care.

The patient, an 83-year-old female with a medical history of type II diabetes mellitus, hypertension, and a long-term smoking habit, was admitted to Aster Hospital, Al Qusais, with symptoms including intermittent chest pain radiating to the left hand, escalating breathing difficulties over months, exacerbated in the past 3-4 days with associated dry coughing.

Reflecting on this intricate case, Dr. Anil Prahalada Rao Kumar, Interventional Cardiology Specialist at Aster Hospital, Al Qusais stated, “Addressing the complexities of cardiovascular conditions in elderly patients demands a meticulous and tailored approach. In the management of this intricate case, our focus encompassed a comprehensive array of treatments and precise interventions, carefully tailored to address the patient’s diverse conditions. The successful outcomes underscore the significance of personalized care strategies, backed by evidence-based practices. From a series of medications including unfractionated heparin, Dual Antiplatelet Therapy (DAPT), statins, IV diuretics, to the precise procedural intervention involving percutaneous transluminal coronary angioplasty (PTCA) to the left anterior descending artery (LAD), our treatment regimen was meticulously crafted.”

Upon examination, the patient exhibited moderate to severe dyspnea, NYHA class II-III, elevated blood pressure (190/110 mmHg), and notable clinical findings consistent with acute diastolic heart failure. Further evaluations, including echocardiogram and coronary artery angiography (CAG), confirmed the diagnosis and guided the treatment plan.

The patient underwent a series of treatments, including unfractionated heparin, Dual Antiplatelet Therapy (DAPT), statin, IV diuretics, and other supportive medications. Following clinical stabilization, she presented with intermittent angina and dynamic ECG changes, leading to a successful CAG revealing Double Vessel Disease. Subsequent percutaneous transluminal coronary angioplasty (PTCA) to the left anterior descending artery (LAD) was performed, achieving optimal outcomes without any procedural complications.

Dr. Anil Prahalada Rao Kumar added, “Elderly patients often present with unique challenges due to their comorbidities and atypical symptoms. The measures, combined with continuous monitoring and adjustments, ensured optimal results without encountering procedural complications. This case exemplifies our commitment to innovative and effective care delivery, particularly in managing intricate cardiovascular conditions prevalent in the elderly.”

Post-procedure, the patient exhibited clinical improvement, was ambulated without symptoms, received optimized medications, and was discharged in a stable condition. This successful case highlights Aster Hospital, Al Qusais’ commitment to delivering exceptional healthcare, especially in managing complex cardiovascular conditions in the elderly population.

Heart diseases continue to be a significant global health concern, affecting over half a billion people worldwide and resulting in 20.5 million deaths in 2021, representing approximately a third of all global deaths. Studies suggest that nearly 80% of premature heart attacks are prevented.[3] When considering Acute Coronary Syndrome (ACS), statistics show that around 60% of hospitalizations due to ACS occur in patients older than 65 years, contributing to an alarming 85% of ACS-related mortality among the Medicare population. Most fatalities associated with myocardial infarction occur in individuals aged over 65 years.^[4] Additionally, in the UAE, cardiovascular diseases (CVDs) stand as the primary cause of mortality, with premature coronary heart diseases (CHDs) occurring approximately 10-15 years earlier than in individuals from western countries.[5]

[1]Goldberg RJ, McCormick D, Gurwitz JH, et al.: Age-related trends in short- and long-term survival after acute myocardial infarction: a 20-year population-based perspective (1975–1995). Am J Cardiol. 1998;82(11):1311–7. 10.1016/S0002-9149(98)00633-X [PubMed] [CrossRef] [Google Scholar] https://pubmed.ncbi.nlm.nih.gov/9856911/

[2] UAE: Cardiovascular disease and Premature coronary diseases  https://pubmed.ncbi.nlm.nih.gov/35593359/

[3]  World Heart Association: https://world-heart-federation.org/wp-content/uploads/World-Heart-Report-2023.pdf

[4]Goldberg RJ, McCormick D, Gurwitz JH, et al.: Age-related trends in short- and long-term survival after acute myocardial infarction: a 20-year population-based perspective (1975–1995). Am J Cardiol. 1998;82(11):1311–7. 10.1016/S0002-9149(98)00633-X [PubMed] [CrossRef] [Google Scholar] https://pubmed.ncbi.nlm.nih.gov/9856911/

[5] UAE: Cardiovascular disease and Premature coronary diseases  https://pubmed.ncbi.nlm.nih.gov/35593359/