[NP-Clinical] Cardiac Questions

[dawnaw at bellsouth.net]

I would advise the family to immediately get a copy of the hospital records.  What did the nurse's notes say, pain scale, vital signs- BP, temp?  How long was he hospitalized before he was discharged? You will be suprised at what you may find.  I just had a horrible hospital experience with my father and when I got the medical records, it was even more devastating.  I found that his PCP lied about several things, but the medical records told everything.  I am very sorry for the loss of your friend, but I am sure the family needs answers.  Keep us updated as to what you discover.

Dawna


> 
> From: "Christine Smith" <chrisbsmith at mindspring.com>
> Date: 2007/02/14 Wed PM 06:36:44 EST
> To: <np-clinical at nurse.net>,  <ACC-Circle at listserve.com>
> Subject: [NP-Clinical] Cardiac Questions
> 
> Need some cardiac thoughts please....
> 
> 70 yo friend went in for some colon polyp removals. Was told it was elective, did not have to occur but advised. Ended up coming out with incision from xyphoid to low abd with gall bladder taken out and partial colectomy. "just took the gall bladder out to prevent future problems". Uneventful hospital course except significant pain that he did not express real well to staff and MD. Dc'd home nauseated but taking PO. Came back 3 hours later dead.
> 
> PMH - COPD, Old Prostate CA now in remission. Had a Stress test and Echo in September which was good "benign ventricular ectopy" and Ejection Fraction of 53%. CXR and a CT scan of the chest done in Sept ((chest pain, R/O PE episode) was negative. Never any documentation of LVH on 12 leads, CXR or anywhere else. Not on any meds, no hx of HTN. Got regular health care. COPD was so controlled not even on meds. Still smoked less than 1 PPD. Patient was very active, retired and fit.
> 
> Reviewed the autopsy report yesterday with family - coroner states he died of LVH. All the other findings were benign - lungs showed some adhesions, as did abdomen, and some sclerosis to the kidneys. No infarction.
> 
> So, can LVH never be diagnosed previously? Is that the sole reason for his death? Family very upset - PCP refuses to talk to them or explain anything. He did not even offer condolescences.
> 
> Patient came home from the hospital, told his wife "I am not going to make it". She thought it was his pain that made him like that. She reassured him. Three hours later he collapsed in his chair and said call 911 and the kids. 10 minutes later, still waiting for 911, his wife told him the kids were there. He immediately went unconscious. Enroute and initially at the ER he was in a rapid Afib and unconscious. Shortly after arrival, despite repeated cardioversion enroute and in ER, he went into asystole and died. 
> 
> He only was on Vicodin when he left the hospital. Prior to that he was on IV abx.
> 
> Thoughts? Family is still in shock and close friends of mine.
> 
> Christine Smith, NP
> 
> 
>