Heart attack and coma: What to expect?

Someone close to me had a heart attack five days ago and went into a coma. The doctors say the stent surgery went fine and there haven't been any complications yet, they're just waiting for her to wake up. I guess I'm wondering if anyone here has dealt with something similar? My whole family is pretty stressed out right now, so if anyone has some insight, it might help.

Ryan Torres27 said:A really close friend of mine had a heart attack about five days ago and ended up falling into a coma. The doctors at the hospital told us that the stent procedure went smoothly without any hiccups, so now we’re just sitting tight and waiting for them to wake up. My whole family is basically a nervous wreck right now because everything feels so heavy—does anyone here have experience dealing with this kind of thing? We could really use some insight or even just a bit of encouragement while we wait.

Look, if you actually understood what they were saying and they gave you that specific info, then the whole situation sounds absolutely insane...
Maybe try laying out the timeline of everything that happened and definitely let us know which unit or ward they're staying in at the hospital.

Has anyone in their family ever dealt with something like this before?

Look, I've been around the block a few times in my career, so I'm asking for more detail because honestly, what you wrote here is just too vague for anyone to actually give you a straight answer. It’s all a bit messy and scattered right now, you know?

Ryan Torres27 said:A dear person close to me suffered a heart attack five days ago and is currently in a coma. The doctors at the Mayo Clinic mentioned that the stent placement surgery went smoothly without any complications, so now we're just waiting for them to wake up. Has anyone dealt with something similar? Our whole family is in a really tough spot right now and everyone is incredibly anxious. If anyone has any insight or experience to share, it would mean the world to us.

How old is the patient?
Did they have a history of heart issues, or did this come out of nowhere?
Are there any other chronic health conditions involved?

So, here’s what happened. My mom was complaining about chest pains, went to the bathroom, and just collapsed. We turned her on her side and made sure her airway was clear. She was struggling to breathe. Paramedics arrived within maybe three to five minutes and started chest compressions immediately. Then she went into clinical death, but they managed to bring her back using defibrillation and adrenaline before rushing her to the hospital. Once there, she had emergency surgery to get two stents put in. Turns out she actually had an old heart attack from over four years ago that nobody even knew about. After the surgery, she coded again, but they brought her back with more shocks—only now she’s in a coma. This all went down overnight between Tuesday and Wednesday, and she’s stable for now. They tried weaning her off the sedatives, but she started getting restless and agitated, so they put her back on them until she recovers. Her heart seems fine, but she’s still on a ventilator. The doctors say we just have to wait for her to wake up and see what happens next. I guess I'm wondering if anyone here has experience with this kind of thing—like how long a coma usually lasts? I keep reading that about 50% of people die within the first hour of a heart attack, and another 45% pass away in the following few days. Has anyone dealt with patients in a similar situation?

She’s 61 and hasn't dealt with any other chronic issues, I guess.

Ryan Torres27 said:It went down like this. My mom started complaining about chest pains, went to the bathroom, and just collapsed. We turned her on her side and made sure her airway was clear. She was struggling to breathe. The paramedics arrived within three to five minutes, and once they got there, they started CPR. Then she went into clinical death, and they had to use defibrillators and adrenaline to bring her back before rushing her to the hospital. Once at the hospital, she underwent an emergency procedure where they placed two stents; they found out she actually had a heart attack over four years ago that nobody ever knew about. After the procedure, she went into arrest again, and even with the shocks, she fell into a coma. This all happened overnight between Tuesday and Wednesday, and she’s been stable since. They tried weaning her off the sedatives, but she started getting agitated and fighting it, so they put her back on them until she recovers. Her heart rhythm is okay, but she’s still on a ventilator. The doctors say now we just wait for her to wake up and see what happens next. I'm wondering if you have any experience with this—like how long a coma lasts and all that. I've been reading that about 50% of people die from a heart attack within the first hour, and about 45% pass away in the following four or five days. Have you dealt with patients like this before?!

Okay, things are a bit clearer now. You haven't told me which specific unit she's in yet, and honestly, that makes a huge difference. When you say she's "on a ventilator," do you mean she's wearing an oxygen mask, or is there an actual tube down her throat for mechanical ventilation?
Part of what you said regarding the stents and the surgery seems a little confused. In medical terms, "surgery" usually implies something like opening the chest for a bypass, whereas placing stents is considered an intervention rather than a full surgical operation. It sounds like a small distinction, but it matters for understanding the situation because those are two very different levels of intensity, even if the goal is the same: fixing the heart.

Regarding your original question... it’s honestly pretty reckless for the doctors over there to claim that "the stent procedure went well without complications and now we're just waiting for her to wake up"...😕...I mean, are they for real?... You can't say something like that about someone who clearly suffered a massive, serious myocardial infarction (and isn't even a first-timer), who required resuscitation, and who might have sustained neurological damage due to prolonged hypoxia...😕....that's just totally wild!...
The body isn't some car where you swap out a part and then "just wait for the engine to turn over and drive away."....it's unbelievable!...🙄....
Regardless of the stents, that heart attack caused real damage to the muscle. A stent helps get blood flowing again through revascularization, but it’s not a magic wand that makes the previous damage disappear. It’s impossible to know how much damage was done to the heart tissue or how much function can actually be recovered with the stent.

Looking at everything you've described and her current state... unfortunately, your mother is a very critical patient and is undeniably still in a life-threatening situation. I don't usually like to "play doctor" on forums because the attending physician has the best view of the situation... but there's no room here for thinking "everything is fine, we're just waiting for her to wake up"... that's just irresponsible...

I'm trying to put myself in your shoes... When you go to visit her, try asking these specific questions:
1. What were her initial troponin levels upon admission, and what are they showing now? It's crucial to see a downward trend. Also, ask about her cardiac output (CO or CI) and whether there are signs of decompensation or, heaven forbid, cardiogenic shock.
2. Are there any signs of neurological damage from the prolonged hypoxia during that gap between losing consciousness and getting them breathing on their own again? That "twitching" or restlessness you mentioned, along with any issues with spontaneous breathing while they're on the ventilator, could point toward some neurological deficits. Since it’s been a few days since everything went down, I'd wonder if they've run a brain CT or MRI yet to check for any visible lesions.
3. What does the PV look like—did they actually hit those target numbers? This is huge because we don't want those stents to clot off. Usually, doctors will put patients on a low-molecular-weight heparin to prevent that kind of thing.
4. How are the lungs holding up? Being stuck on a ventilator for an extended period almost always leads to stuff like pneumonia, fluid buildup, or atelectasis. You might want to ask the medical team if they plan on keeping them ventilated and when they intend to perform a tracheostomy. It’s a big deal; getting a percutaneous tracheostomy done early for someone who's been on a vent for a few days can really help with weaning them off the machine and just makes lung ventilation much more effective overall.
4. Is the patient getting nutrition through a feeding tube, and is it enough? There's no point in all the meds and interventions if they aren't actually getting calories into their stomach via a tube.
5. If they aren't using a feeding tube, then they absolutely need to be getting nutrition intravenously through a central line. And I don't mean just a basic glucose and electrolyte drip... they need actual parenteral nutrition formulas like Aminomix, Kabiven, or Intralipid.
6. Is there a physical therapist working with her on passive exercises? Or maybe even some range-of-motion work if that's allowed?
....

Man, my mind is just racing with questions here... honestly, your best bet is to just lay these out to the staff right where you are. And please, don't let them brush you off with vague nonsense like "everything is fine, we're just waiting for them to wake up." Hang in there...

Is there any definitive medical consensus on whether hypoxic brain damage actually occurs following cardiac arrest?

Are they actually serious? I mean, you can't really say that about someone who just went through a massive, life-threatening heart attack—especially not their first one—who had to be resuscitated and might have neurological damage from being without oxygen for too long. It’s just completely irrational.

...You misunderstood me. They said they did their jobs well, or at least did the best they could given the circumstances, specifically by getting blood flow back to parts of the heart that were damaged during the initial attack.
...They didn't mention any brain damage yet, because the neurologist who visited couldn't get a clear read on things since she's still heavily sedated... which she is, because once they tried to wean her off the meds, she started getting agitated and restless, which isn't great for her heart condition.
The same thing happened when my father visited; she got worked up and then went into ventricular fibrillation, requiring resuscitation twice. For the 24 hours prior, her heart was stable with no arrhythmias, extra beats, or fibrillation.

...Nobody promised everything would be fine. They just said they have to wait for her to wake up before they can assess the extent of any damage.
...She’s on a ventilator now. Two days ago, she was breathing almost on her own, but now she needs the machine because breathing independently was clearly too much strain on her.
Her pupils are constricted. They say that's a good sign, though I guess it doesn't necessarily guarantee anything.
Given her condition and the fact that she's on a ventilator and a defibrillator, it’s probably impossible to move her for a CT scan. It wouldn't make much sense anyway, since the exact percentage of damage doesn't change much right now... what matters more is if she can actually wake up from this coma.
...Her ejection fraction has dropped to 30%... they're monitoring her blood pressure and urine output to manage potential edema... they're basically tracking all her metabolites; they even had to supplement her magnesium last night.
...As for nutrition, I assume they're feeding her normally, considering she's in the ICU.
...There hasn't been any talk about physical therapy yet; I suppose it's way too early for that.
We're just hoping things don't take a fatal turn while everything is still this unstable.

What kind of experiences have you guys had with patients like this? How long does a coma typically last?

Eric Wright29 said:Is there any actual proof that brain hypoxia didn't occur during the cardiac arrest?

Not at the moment, I guess.

Ryan Torres27 said:There isn't one right now!

It's actually possible they’re keeping them in a medically induced coma if the pain is just too much to handle.

From my own experience working in healthcare, I know some people need a couple of days just to fully shake off the effects of general anesthesia.

Either way, if this state persists, they’ll likely want to consult a neurologist or run some brain imaging.

Eric Wright29 said:They might even have her in a medically induced coma if the pain is just too much.

From what I've seen, it can honestly take some people a couple of days just to fully snap out of anesthesia.

Either way, if this persists, they'll probably end up calling in a neurologist or ordering some brain scans.

All they told us was that she's in a light coma and they're using sedatives and pain meds to manage it.

Ryan Torres27 said:They told us she's in a shallow coma, and they're giving her sedatives and pain medication.

There’s something called the Glasgow Coma Scale used to determine how deep a patient's coma actually is. Since they are administering medication, I assume the coma isn't drug-induced. She should wake up; we just need to be patient.

Once she's out of surgery, keep a close eye on Mom to make sure she doesn't suffer another heart attack anytime soon.

Watch her medications closely and stay alert for any signs of blood clots.

Eric Wright29 said:There’s a thing called the Glasgow Coma Scale used to measure how deep a coma is. If they're administering meds, I assume the coma isn't drug-induced. She'll probably wake up; I guess we just have to wait a bit.

And we should probably watch over her post-op, just to make sure she doesn't suffer another heart attack anytime soon.

Keep an eye on her medications and watch out for potential thrombosis, too.

Thank you all for the comfort, it really means a lot. The whole family is under massive stress, exhausted and on edge from the waiting, so every kind word helps. Your optimism sounds like what we need—I pray she wakes up soon so this nightmare can finally be over. Thank you!