'Taraka Ratna episode highlights need for defibrillator in public places'

Hyderabad, Jan 30: Heart attack among youngsters is common nowadays and multiple reasons have been attributed to it. Changing lifestyle, sedentary behaviour, smoking, alcohol intake, improper food habits, obesity are few of the causes.

Doctors say sudden cardiac arrest is a devastating complication among this age group. In the case of Tollywood actor Taraka Ratna (39), the video shown in the media suggests he suddenly collapsed, probably due to heart attack leading to arrhythmias (electrical irregularity) followed by stopping of heart(cardiac arrest).

According to Dr Hari Ram, Senior consultant and head, interventional cardiologist, SLG Hospitals, in this case immediate bystander Cardiopulmonary resuscitation (CPR) and defibrillation (shock) along with the correction of the cause of cardiac arrest is the treatment of choice.

"Each second's delay decreases the chances of survival. Bystander CPR can be initiated by the public also, we need to give training to the public regarding the basic level of CPR. Cardioversion/Defibrillation is available in hospitals only (Defibrillator), these types of machines called AED (Automatic external defibrillator) can be made available in public areas and the public needs to be trained," he said.

The cardiologist says while AED are available in airports and hotels, people need to know how to use this device. Delay of initial treatment leads to decreased blood supply to all important organs like heart, brain, liver, kidney, gut and lungs.

Health bulletin released by Narayana institute of cardiac sciences mentioned that resuscitation time (ROSC time) was 45 minutes which is very high which can lead to multiple organ failure. The doctors in Kuppam immediately did balloon angioplasty and placed on Intra Aortic Balloon Pump (IABP) and vasoactive drugs. He remained in a critical condition on maximum support.

Dr Srinivas Jakkinaboina, Senior consultant and Head, Critical care medicine from SLG Hospitals predicts the condition of Taraka Ratna might be critical. The challenge before doctors is maintaining the tissue perfusion to all the organs by adequate blood pressure and oxygen.

They can take the help of Veno Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for maintaining BP and oxygen, Kidney support can be given with Continuous Renal Replacement Therapy(CRRT).

While supporting all the organs the corrections are made to improve the cardiac function either by surgical or non surgical methods.

Brain function needs to be assessed during this process at regular intervals. As ROSC time was high so there is need to have a close watch on brain function.

"We pray to god for his speedy recovery, we analysed whatever is the information from the medical bulletin release. We all know prevention is better than cure. Everyone should know our numbers in terms of BP, blood sugar, cholesterol and also to undergo cardiac evaluation in terms of ECG, TMT and 2D ECHO if we encounter any symptoms," he said.

Lifestyle modifications in the form of regular exercise, healthy diet, quitting alcohol and smoking are important for the heart, he added.