An evening in the emergency department
The urological assistant doctor was on duty, but the young woman lying on the hospital bed was not having any kidney or bladder problems. She was gasping for air. Immediately he reaches to his phone and calls Dr Martina John: “The patient’s pulse is 220/min and has reached the stage of cardiac failure – what shall we do?” “Give her a dose of Lasix and oxygen, I’m coming immediately!”
The missionary doctor reaches the bedside a few minutes later. The young Quechua-Indian has travelled a long way from the distant city of Sicuani. Her heart has been racing for a week. As soon as her fear turned into despair she left her home with her family: her husband, her four-year old daughter and her infant. She endured a well over seven hour journey through the Andes to reach the hospital about which so much is talked about in Southern Peru: the Hospital Diospi Suyana.
“I cannot breathe anymore,” gasps Vernadina. Her bluish facial expression underlines how she is feeling. Due to insufficient cardiac output she now has a fulminant pulmonary oedema, i.e. her lungs are full of fluid. Dr John injects the first Antiarrhythmicum into her veins, the second one follows shortly afterwards in order to flush out the fluid. The third medication will reduce her heartbeat.
“It won’t be long now until the patient collapses and needs to be given oxygen,” thinks the doctor and calls Dr Malisi, an anaesthetist; just the right person for an emergency intubation.
The medications are starting to take effect. Her pulse is now at 150, the anaesthetist supports her breathing with a mask and the supply of oxygen soothes her keen hunger for air. Vernadina takes heart: “I can survive here,” whizzes through her head, “the doctors are there for me!”
That night on the A+E her kidneys excreted 2.5 litres of water and her lungs could finally start to be aired properly. Over the next few hours her heartbeat came back to normal levels. Two days later she could leave the intensive care unit and was discharged from the hospital five days later.
On Wednesday our cardiological ultrasound specialist John Lentink (he and his family had just returned from a holiday-break outside of Peru) had a closer look at Vernadina’s heart: probably one of her cardiac valves did not function properly. The data gathered will help find the exact diagnosis.
