It did not occur to Mr. Ramalingam K. that anything out of the ordinary would happen following his health check in December.
However, the 42-year-old father of two, who has been married for 13 years, ended up having to grapple with two heart attacks and successive organ complications. In short, he fought for his life starting from a night in February.
He initially sought medical attention at Farrer Park Hospital (FPH)’s 24HR Medical Urgency Clinic for pain on the left side of his chest. The pain kept him from sleeping well. He arrived at FPH pre-dawn, having almost lost consciousness, and was attended to immediately by the medical team onsite.
Talking about the events that led to his medical ordeal, Mr. Ramalingam said that he did not have a prior history of heart issues. To say that he, his wife and their two daughters, aged eight and 12, were taken by surprise is an understatement.
But the family is a resilient one, adjusting accordingly to what the pandemic has brought about. Mr. Ramalingam, an engineer by training, is a design lead for a multinational company and has been based in Singapore since 2015. His initial complaint arose from vomiting and fever. The thought of sustaining a heart attack did not cross his mind.
He would encounter a stay in FPH’s intensive care unit and endure complications that led to implanting a device in his heart to address irreparable damage. Doctors tending to his heart, lungs, kidneys and digestive functions worked in sync and collaborated for the best outcome.
In Mr. Ramalingam’s case, it became apparent in the course of a month that the goal was to save his life.
Cardiologist Dr. Eric Chong firstly addressed Mr. Ramalingam’s very low blood pressure. After confirming that he sustained a heart attack, the blockage discovered in his arteries was alleviated and Dr. Chong used a balloon pump for his heart to stabilise his condition.
The blockage in his arteries was at 100%. Mr. Ramalingam’s condition was critical.
- Dr. Eric Chong, Cardiologist
The treatments were preceded by an onset of pneumonia, and Mr. Ramalingam was given the assistance of a ventilator to help his breathing. Mr. Ramalingam’s health was severely challenged in the span of 24 hours. In addition, his liver and kidneys became affected and blood clots which were discovered in his system were removed by suction.
At one point, owing to difficulties with digesting food, Mr. Ramalingam was given milk intravenously. The issues with his digestive system resulted in a bloated stomach.
According to Dr. Chong, Mr. Ramalingam’s affected arteries were temporarily helped but given the severity of his overall condition, a decision had to be arrived at.
“You could say using the HeartMate device was the best and only viable option to save his life,” Dr. Chong said of the decision that was made.
The HeartMate device is a left ventricular assist device or LVAD. A mechanical circulatory support, it is used for advanced heart failure patients needing it both short- or long-term.
An LVAD works essentially as a pump in the heart that addresses weaknesses of the heart with contraction or expansion. Implanted in the heart, it takes over the work of the left ventricle, one of the heart's two lower chambers, and helps the heart pump oxygenated blood to the body when it isn't healthy enough to do so. This lessens the heart's workload and alleviates symptoms such as shortness of breath and weakness, while improving the recipient’s exercise capacity and prolonging their chances of survival.
The device can be used as an intermediary measure while patients await a transplant in the case of heart failure. Implanting an LVAD can also be used as a therapeutic measure without planning for a heart transplant. Practically, after an implantation, a patient can recover with the benefits of mobility and a stable flow of blood into and out of the heart.
When Mr. Ramalingam first struggled with his symptoms, his wife and their daughters were in Chennai. Even with his wife arriving in Singapore to be with him, the decision to go ahead with an LVAD implantation was not a straightforward one.
Dr. Lim Chong Hee, the cardiothoracic surgeon who carried out the procedure remarked on Mr. Ramalingam's tenacity to go through with his treatment.
Mr. Ramalingam understood the benefits and risks of such an implantation. He was ready and willing to undergo the procedure in the midst of a trying situation.
- Dr. Lim Chong Hee, Thoracic & Cardiovascular Surgeon
Dr. Lim, who served at National Heart Centre Singapore before going into private practice and was involved in pioneering the implantation of LVADs at the centre, noted that Mr. Ramalingam suffered a second heart attack while in intensive care.
Mr. Ramalingam’s LVAD implantation took place on 3 March.
The nearly two-and-a-half-hour procedure required him to be assisted by a heart and lung bypass machine. Close monitoring of his condition was carried out by a team consisting of cardiologists, including Dr. Eric Chong, the surgical team and an anesthesiologist, to ensure the successful implantation of the LVAD. The surgery was followed by a short stay at the Intensive Care Unit where he was closely monitored to ensure he was able to breathe on his own, and that his condition had stabilised before he was transferred to an Inpatient Suite. He spent two more weeks in the hospital before Dr. Lim gave him the all clear to continue recuperating in the comfort of home.
Mr. Ramalingam recovered well with his family’s support and the assistance of his care team at Farrer Park Hospital.
