Our Community

Maru first came to our ECC and Internal Medicine teams at The Ralph for treatment for a pleural effusion, a condition where fluid accumulates in the chest. After undergoing a CT scan, she had chest drains placed to help remove the fluid. Samples from the drains were sent to the laboratory for analysis, and the results revealed that Maru’s pleural effusion was actually a chylothorax – a condition in which lymphatic fluid, or chyle, accumulates within the chest.  As chylothorax is typically a surgical condition, Maru underwent a thoracotomy (a surgical incision between the ribs) to ligate the thoracic duct which was responsible for the accumulation of lymphatic fluid. Simultaneously, a pericardiectomy (removal of the sac surrounding the heart) was performed as part of the treatment protocol.

Maru initially recovered well in our ICU, with her chest drains being removed just two days later. However, a few days after that, our ECC team noticed that Maru was experiencing severe bradycardia, a dangerously slow heart rate. Our Cardiology team performed an ECG and started Maru on medications to stabilise her heart rate. Also, Maru was showing signs of anaemia, prompting our ECC clinicians to administer a blood transfusion in order to increase the number of haemoglobin (oxygen carrying cells) in her blood, thus improving oxygen delivery to her heart muscle, helping to alleviate some of her cardiac symptoms.

By the next day, Maru appeared much brighter, and her heart rate had improved. Our Cardiology team then placed a Holter monitor – a device that provides a 24-hour ECG trace to track her heart’s rhythm. The results showed that Maru had an abnormal heart rhythm, with pauses of 10-12 seconds between beats, indicating that she might need a pacemaker.

After being discharged, Maru continued her recovery from the thoracotomy and followed up with our Cardiology team a week later. Although she had been stable at home, Maru experienced a few episodes of fainting. To investigate further, we sent her home with another Holter monitor, which confirmed the need for a pacemaker. The procedure went smoothly, and the pacemaker was programmed to regulate her heart rate at a fixed rate when needed.

Two weeks after the pacemaker was fitted, Maru returned for an interrogation of the device, where the pacemaker’s data was analysed. The results showed that the pacemaker was functioning well, with Maru’s heart rate stable and only a few beats requiring pacing.

Six months later, Maru came in for another pacemaker interrogation. The data revealed that 60% of her heart rhythm was now dependent on the pacemaker. Our Cardiology team will continue to monitor her progress, but for now, they are very pleased with her recovery!

Thank you for reading Maru’s story. For regular patient stories and news from The Ralph, follow us on Instagram, Facebook and LinkedIn.

Take care,

Team Ralph 🐾