Posted by By Meghan Holohan November 7, 2022 on Nov 12th 2022
A cardiologist opens up about his heart attack and a lifesaving procedure: “Makes you humble’
A cardiologist opens up about his heart attack and a lifesaving procedure: “Makes you humble’
Dr. Naresh Mistry's experience has changed how he thinks about his role as a doctor.
After finishing a 12-hour workday, Dr. Naresh Mistry felt worn down when he got home and tried napping. But sleep evaded him. As he walked downstairs, he began experiencing intense shortness of breath and shoulder pain. The cardiologist knew exactly what was happening.
“This looked like heart attack symptoms to me,” Mistry, an interventional cardiologist at Covenant Health in Knoxville, Tennessee told, TODAY. “We said, ‘OK, let’s go to the ER.’ I try to get in the car and as we come out of the driveway, the symptoms get worse. Then I said, ‘I think this is not a good idea.’”
Instead, he and his wife called for an ambulance. As the EMTs arrived, he shared his symptoms.
“I laid down on the gurney. (Up) until then I was able to talk and communicate,” he said. “I passed out. I do not remember after.”
Heart attack and resuscitation
When the shortness of breath and shoulder pain began, Mistry also called his partner in his cardiology practicewho urged him to go to the emergency department. But his health quickly worsened, and he thought it would be safer in an ambulance. Although he called 911, his wife needed to talk to them. Even though he doesn’t remember being in the ambulance, he did pepper them with his health history and symptoms.
“I was giving them my history, which I don’t recall,” he said. Upon arriving at Parkwest Medical Center, doctors confirmed he was experiencing acute cardiac event and they rushed him to the cardiac catherization lab.
“They found a multi-vessel blockage,” Mistry explained. “The surgeon was called and then the decision ultimately was made to intervene on one vessel called the left anterior descending arteries and the stent was put in.”
After the stent was placed, Mistry was going to be moved to the cardiac intensive care unit, but he asked the technician to wait.
“I said, ‘Jamie, don’t take me off the table yet. Just keep me here for now.’ So, he did not put me in a bed. I was on the cath table,” he said. “The next thing they knew I was coding — meaning I was having cardiac arrest.”
Mistry's colleague, Dr. Gregory Brewer, was in the catherization lab when Mistry began coding. In the back of his mind, Brewer thought of how Mistry’s father died of a heart attack at 65. He didn’t want history to repeat itself.
“Dr. Mistry proceeded to go into life-threatening rhythm. We ended up doing a code blue for about two hours with chest compressions and shocking the heart,” Brewer, an interventional cardiologist at Parkwest Medical Center, told TODAY. “We ended up putting in what’s called an Impella, which is a specialized device, a ventricular assist device, that can sustain a patient even if their heart’s not beating.”
Brewer said that normally someone who hasn’t been resuscitated within 40 minutes is at risk of permanent brain injury. But they had a doctor managing Mistry’s airway while he received compressions that helped Mistry stay oxygenated.
“It was touch and go there,” Brewer said. “Even after we do all these efforts — the recovery period — we always have to worry about the loss of brain function from such a prolonged exercise.”
Throughout the two hours of CPR, Brewer worried he would soon need to deliver bad news to Mistry’s family.
“You don’t know how many times I thought I was going to have to go outside the cath lab and discuss with his wife that Naresh wasn’t going to make it,” Brewer said. “I’ve been personal friends with Dr. Mistry for many years and it’s difficult. You've just got to stay focused, identify the problem solve the problem … you’re not guaranteed anything in this world.”
After the Impella was placed, Mistry went to the cardiac intensive care unit and was cooled, what's called a hypothermia protocol, and intubated. As he stabilized, they removed the Impella and took him off the ventilator. It soon became clear he did not have a brain injury due to the sustained CPR.
“I recovered after a few days,” Mistry said.
Helping a close colleague and friend felt “very meaningful” to Brewer.
“The whole meaning of life for me is looking forward to time with friends and people I love,” he said. “That has been given to Dr. Mistry.”