An 87-year-old woman was recently operated upon for a fall at home, unusually, just as she was recovering from a heart attack.
Kamalabai, a resident of Thoraipakkam, was recovering from acute myocardial infarction for which she was treated at a private hospital earlier. Soon after she returned home, she had a fall, which broke her femur. Her family sought treatment at a private hospital at Nanganallur.
“The patient was recovering from myocardial infarction. Usually we don’t do surgery for at least three weeks after an attack of myocardial infarction. But in her case, as she had sustained a major fracture, she had severe pain, which could lead to another attack. We decided to operate to relieve her of her pain and to avoid further complications,” said V. Sivakumar, orthopaedic surgeon, Sivam Hospital.
The hypertensive octogenarian is also obese, the doctor said. Her heart was functioning at 30% of its capacity. But postponing the surgery would cause further complications, he added. The patient was given epidural anaesthesia and an implant was provided surgically five days ago. She is undergoing physiotherapy at the hospital. Post-surgery, her heart ejection fraction improved to 40% as she was able to move. She now walks with a walker.
“The unique factor is that the patient had not recovered from myocardial infarction. Only 10 days prior to the fracture, she had suffered a heart attack. Because of this, her heart ejection fraction is low. Without aggravating her heart condition, proximal femoral nailing was done under epidural anaesthesia [which is safer for the heart condition], instead of the general anaesthesia,” Dr. Sivakumar said.
