In a startling incident of unusual treatment done right, a procedure at the city’s Noble Hospital three days ago saw a patient given 100 per cent alcohol to trigger a heart attack, so as to save him from a life-threatening condition and severe morbidity. The 42-year-old patient’s condition of hypertrophic obstructive cardiomyopathy, which is mainly a genetic heart disease, is not very common and usually needs open heart surgery to improve blood flow.

In this case, the patient came in with severe breathlessness and chest pain. He was diagnosed with severe hypertrophic cardiomyopathy, in which blood flow to the heart gets majorly obstructed through a thickened muscle. “The only way to treat it is to open the heart and cut off the obstructing thickened muscle. But, looking at the patient’s condition, we decided to avoid morbidity that comes with open heart surgery. With the patient’s consent, we decided to perform the alcohol septal ablation treatment,” said Dr Rahul Sawant, senior cardiologist at Noble Hospital.

Explaining the procedure, he said, “It includes injecting absolute alcohol in a tiny branch of the coronary artery using a long thin tube. This further induces a small heart attack, which later controls obstruction of blood flow across the main chamber of the heart within 10 minutes.”

During the operation, the patient was injected with 1.5 ml of 100 per cent alcohol into a small branch artery, triggering an attack. “This not only affected the diseased thickened muscle, but also killed it, helping normalise the blood flow,” said Sawant, adding, “In this condition, the muscle usually becomes abnormally thick, making it harder for the heart to pump blood. Often, it goes undiagnosed as many live with no significant symptoms. However, a small number of people suffer from shortness of breath, chest pains or problems in the heart’s electrical system, resulting in abnormal rhythms or sudden death.”

He further said, “We have never performed this procedure on any patient so far. This is a first. And, he has improved dramatically since.”

Several other cardiologists stressed on the expertise and skills required to perform the uncommon procedure successfully. Dr Rahul Patil, senior cardiologist at Ruby Hall Clinic, said, “It is an extremely critical procedure. Not many can perform it, so it is avoided. The alcohol content and timely control of the heart attack requires great patience. Also, often alcohol is avoided to prevent religious issues from cropping up; so, this option goes undiscussed. However, once performed, the treatment can give extended life; open heart surgery carries chances of severe morbidity and mortality.”

Dr Ranjit Patil, consultant cardiologist at Sahyadri Hospital, said, “There are very few doctors across India that perform this procedure, and only a handful of these have done it successfully so far. The thickened muscle is usually resolved by going under the knife, but alcohol septal ablation or injecting alcohol in the heart is very uncommon and needs well-trained doctors. It is a procedure that can be risky, too, in case alcohol content is not handled properly. Pune has pulled off a unique instance.”