Q: My 30-year-old brother was very healthy and took exercises daily. One morning he felt a light pain in the chest. Suddenly the pain became severe and we took him to the hospital. He went to hospital about 200 metres on foot. Doctor checked his BP and said its high. He gave him one injection and glucose. After that he went off to sleep. After 10 minutes the doctor gave him oxygen because he couldn't breathe properly. After 10 minutes the doctor said that it is a heart attack and took him to a heart institute. Doctor removed his oxygen when we were taking him to the heart hospital. Within half an hour he died. Can an MBBS doctor cure such a problem? What medicines could the doctor give at that time? If a person is not breathing properly, should oxygen be removed? What is the cause of my brother's death?

A:Your brother has died a sudden cardiac death following severe chest pain. The commonest cause of this sad outcome is an acute myocardial infarction (heart attack) followed by a cardiac arrest due to electrical instability of the heart (ventricular fibrillation). This phenomenon occurs in up to 25% patients within one hour of the onset of symptoms. All patients with acute chest pain should have an ECG recorded as early as possible to diagnose the problem. This should be followed by aggressive management to open the blocked artery by medicines or other methods. Earliest hospitalisation is a must and till that can be done pre hospital management consisting of administration of Aspirin, blood thinners and supportive treatment is recommended. Awareness of the problem and correct diagnosis is the key and not the qualifications of the doctor. All medical personnel should be aware of this possibility and the management guidelines.