A 58-year-old pilgrim from Uttar Pradesh, whose heart stopped multiple times after he reached remote, 11,500-foot-high-altitude Kedarnath Dham during the ongoing Char Dham Yatra, has survived following days of intensive treatment, repeated resuscitation efforts and a difficult evacuation from the Himalayan shrine.
The pilgrim, a resident of Ballia district, had completed the demanding trek to Shri Kedarnath Ji Dham nearly a week ago when he began experiencing severe chest heaviness and discomfort.
The symptoms persisted for almost two hours before he was brought to the Swami Vivekanand Health Mission (SVHM) at Kedarnath.
What initially appeared to be a serious cardiac emergency soon turned into a race against time.
Dr. Vinay Kumar, Assistant Professor (Critical Care) at GIMS Greater Noida, UP who is serving voluntarily at Kedarnath during his summer vacation, was among the first doctors to assess the patient.
“The patient had a history of type 2 diabetes, hypertension, dyslipidaemia and coronary artery disease. On examination, his pulse rate had dropped to just 34 beats per minute, while his oxygen saturation was low and blood sugar levels were dangerously elevated,” Dr. Kumar told The Health Outlook.
Further investigations revealed the gravity of the situation. An electrocardiogram showed complete heart block, a life-threatening condition in which electrical signals fail to travel properly through the heart, causing the heartbeat to slow dramatically or stop altogether. Blood tests revealed severe metabolic acidosis and uncontrolled hyperglycaemia, indicating that the body was already under significant stress.
Treating such a patient in Kedarnath presents unique challenges.
“Given the seriousness of the condition and the limitations of providing advanced cardiac care at an altitude of over 11,000 feet, our team acted immediately,” said Dr. Kumar.
Working alongside nursing officers Naveen, Narendra, Akshay and Ravi, the team initiated advanced life-support measures without delay.
“The patient was placed on continuous cardiac monitoring. Our team provided oxygen support, insulin therapy and correction of metabolic and electrolyte imbalances. Emergency transcutaneous cardiac pacing was also initiated to maintain the heart rate," said Dr. Kumar.
Despite these measures, the patient's condition continued to deteriorate.
“He suffered multiple episodes of cardiac arrest with documented asystole,” Dr. Kumar recalled.
Asystole is one of the most critical cardiac emergencies, marked by the complete absence of electrical activity in the heart. Each episode demanded immediate intervention.
The medical team repeatedly initiated Advanced Cardiac Life Support (ACLS) protocols. Multiple rounds of cardiopulmonary resuscitation (CPR) and emergency shocks were administered as doctors fought to restore circulation.
After sustained efforts, the patient responded.
Doctors were able to achieve a return of spontaneous circulation, reviving him after repeated cardiac arrests.
But the crisis was far from over.
Doctors knew that the definitive treatment for complete heart block would require implantation of a permanent pacemaker at a tertiary-care centre.
Hence, an emergency air evacuation to AIIMS Rishikesh was planned, and when weather became conducive, the patient was airlifted from Kedarnath to Phata and then shifted by road to Government Medical College, Srinagar. From there, he was referred to AIIMS Rishikesh for specialised cardiac care.
“This successful rescue also underscores the critical importance of strengthening emergency preparedness and coordinated evacuation systems in remote pilgrimage destinations across India,” said Dr. Kumar. These high-altitude pilgrimages are visited by lakhs of visitors, including devotees, every year, many of whom are elderly and have underlying health conditions.
