Former Tamil Nadu Chief Minister J Jayalalithaa was breathless, unstable and not responsive to calls when a medical team from Apollo was rushed to attend to her at Poes Garden on September 22 last year at 10 pm.
A treatment summary of the late AIADMK CM, who passed away on December 5 after being hospitalised for 75 days, states that the team found she had low oxygen saturations (approx 48%) and had an initial pulse rate of 88/minute and blood pressure of 140/70.
Though Apollo press releases said she had been admitted with fever and dehydration, medical reports say she was admitted in a critical condition.
There were also indications that she was suffering Pulmonary edema where excess fluid is present in the lungs. She was suffering from fever for around six days when she was hospitalised.
What happened on Day 1, just after she was admitted to the hospital
She was rushed to the ER of Apollo at Greams Road in the next 25 minutes where it was noted that she had "altered sensorium (drowsy and not consistently responding to verbal commands) and in respiratory distress".
Her oxygen saturations was 94% and she was given a non-rebreathing mask (the mask is used to deliver oxygen therapy).
She was found to have Sinus Tachycardia. NetDoctor explains this as a condition where "high pulse rate (is) caused by being worked-up, occasionally as a physiological response to such things as fever or bleeding, but more often as a result of the adrenaline that flows in response to stressful circumstances".
The outer part or the body was "warm with bounding pulses and oedematous", a condition marked by an excess of fluid in a tissue.
Further examinations revealed bilateral basal crackles- abnormal breath sounds caused by excessive fluids within the airways- in the lungs, soft heart sounds, and clinically normal abdominal examination.
She also had severe Bradycardia (slow heart rate) and hypotension (abnormally low blood pressure) in the initial few hours.
She was treated for pericardiac arrest situation, i.e. the period just before or just after a full cardiac arrest when the condition of the patient is still unstable.
Atropin and a temporary transvenous pacemaker was inserted by a cardiologist.
Lab reports also revealed Leukocytosis or increase in the number of white blood cells.
A chest X-Ray done at admission revealed bilateral infiltrates in the middle and lower lung fields. Infiltrate is either fluid, puss or secretions within the the lung sacs.
It was also noted that she had "a recent Out Patient Urine Culture that grew E coli with <105 colony forming units CFU".
Past medical history
According to the medical reports released by the state government, Jayalalithaa had a history of multiple medical ailments.
- poorly controlled diabetes
- irritable bowel syndrome, with chronic diarrhoea
- chronic seasonal bronchitis
She was also on a tapering dose of oral steroids initiated for atopic dermatitis, commonly known as "eczema" (which is associated with inflammation of the skin), where the skin becomes extremely itchy.
There was a history of intermittent fever for 5-7 days with increased frequency of bowel movement.