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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Heart Attack. Had Arteries Repaired. On Morphine. Now What?

My friend had a major heart attack - they were able to repair the arteries, but they say he is brain dead, they took him off the ventilator three days ago. He is on a continueous drop of Morphine to make him comfortable, he has phenomena now. They say his vitials are good. How long can he go on like this. Whe I asked another friend they said that his brain stem isn t dead yet, can that be true?
Tue, 19 Mar 2013
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Internal Medicine Specialist 's  Response
Hi,
Thanks for posting your query.
History of heart attack with brain dead could be sue to decreased blood pressure with hypoxic / hypoglycemic encephalopathy.
Brain dead means non-functioning of cerebral cortex.
While respiratory centre and heart centre are present in brain stem (made up of pons, medulla and mid brain), persistence of life with maintained blood pressure and respiration indicates well maintained brain stem.
Although it indicated bad prognosis but you shouldn't loss your hope and keep your fingers cross.

Take care,
Dr. Mayank Bhargava
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General & Family Physician Dr. Gopal Krishnam Raju's  Response
Brain death is the irreversible end of all brain activity (including involuntary activity necessary to sustain life) due to total necrosis of the cerebral neurons following loss of brain oxygenation. It should not be confused with a persistent vegetative state. Even after brain death, the working of the heart might continue at a slow pace, but there will be no "respiratory effort".

but as you said he`s not on ventilator by above definition ur friend is not brain dead :)
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Had Heart Attack. Had Arteries Repaired. On Morphine. Now What?

Hi, Thanks for posting your query. History of heart attack with brain dead could be sue to decreased blood pressure with hypoxic / hypoglycemic encephalopathy. Brain dead means non-functioning of cerebral cortex. While respiratory centre and heart centre are present in brain stem (made up of pons, medulla and mid brain), persistence of life with maintained blood pressure and respiration indicates well maintained brain stem. Although it indicated bad prognosis but you shouldn t loss your hope and keep your fingers cross. Take care, Dr. Mayank Bhargava