My friends mother died recently. It all started early in the morning. She forgot to take her high BP tablet the night before. Early morning she started vomiting with severe headache, nausea and her lower body below vest was sort of paralysed. My friend gave her two 25 mg tablets Enam-25 and she was rushed to the nearby hospital. There ECG did not show any heart attack. Later they checked sugar, electrolyte, lipid profile. All reports were normal. An echo test was done showing normal valve functioning but 40% LV diastolic contraction. The heart specialist said it's with in the normal range but suggested that treatment be started. She was injected and a tablet was given. After taking tablet she vomited and then collapsed. Nothing worked out and she was declared dead. Now my friend is worried that was it a mistake to give two 25 mg tablets to control BP? Did that dose mislead the heart specialist? The doctors were informed that she had been given two tablets. Was one tablet enough and would that have given true information in echo test or ECG? Could anybody explain. Please tell.
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The tablet you have quoted is not available in the strength of 25 mg. It is sold in strengths of 2.5, 5 and 10 mg. So there is no possibility of giving 50 mg of the medicine at one go. 2 tablets of 2.5 mg makes it 5 mg only and that is normal dose for any patient and should not be the cause of any untoward happening. Even if the initial ecg was reportedly normal it does not rule out ongoing infarction process at that moment and is reflected about 2 hours later as trop t test coming positive. Another severe coronary blockade might have caused the cardiac arrest. These are only possibilities in retrospect. The damage is done and the loss is final. Stop thinking about that and look forward to be more careful in following treatment prescriptions.
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Two tablets of enam 25 (enalapril) would not cause death of a patient- moreover, your friend's mother wasn't told to have low blood pressure when she reached the hospital. The sudden collapse that you have detailed was perhaps an episode of arrhythmia (irregular heart rate) - which causes sudden cardiac deaths. Its very difficult to come to terms with such a tragedy in life - but I can tell you only one thing out of my own experience - its never anybody's fault! she was in the hospital and still she died - make your friend accept this.
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