How does a heart attack progress to death in severe cases?

Question

Hello doctor,

My sister had a heart attack nine years ago. Two days after being admitted to the hospital, she underwent diagnostic coronary angiography. The decision was made to treat her with coronary angioplasty of the right coronary artery. During the procedure, a dissection developed in the right coronary artery with significant involvement of the ascending aorta. My question pertains to when my sister would have become aware of what was happening. Would she have lost consciousness when the dissection occurred? She was transported by ambulance and experienced two cardiac arrests during the journey. Unfortunately, she passed away after the bypass surgery. For our peace of mind, we would like to understand at which point she would have been aware and what her final moments may have been like. I would greatly appreciate it if you could explain what it might have been like.

Thank you.

Answer 1

Hello,

Welcome to the icliniq family.

I understand your emotions, and I am sorry for the loss of your loved one. Please accept my condolences. I have carefully read through your explanation, and based on that, here is my conclusion: Your sister may have developed a dissection as a result of the mechanical injury that occurred during the attempt to remove the blockage in her right coronary artery. In some cases, a more aggressive approach is needed for certain blockages. As a result, an extensive dissection occurred, and she may or may not have experienced chest pain (the doctors would have had more information about this at the time of the dissection). At this point, the condition rapidly progressed to a heart attack, and it is likely that she lost consciousness before tragically passing away on the way to the hospital. I hope this explanation brings some relief to the pain you are experiencing and provides you with a sense of peace.

I hope this has helped you. Thank you.