Red Alert – Flatline

The patient, an 80-year-old man hospitalized in Hillel Yaffe Medical Center's Cardiac Intensive Care Unit, underwent catheterization due to angina and was admitted for continued monitoring and treatment. During his hospital stay, a Red Alert air raid siren sounded due to rocket fire. The man, who was connected to a monitoring device (telemetry) that displays all his vital signs, was quickly evacuated along with other patients and staff to a protected area 25 meters from his bed. Moments after arriving in the protected space, without any warning symptoms, the patient collapsed, fainted, and underwent brief resuscitation, which was successful.

"When we examined the data on his telemetry device," said Dr. Adam Polman, the cardiologist who treated the patient, "we saw complete documentation of a severe cardiac event – in other words, a flatline and absence of pulse. The man was, in effect, in a state of death for at least 10 seconds, and this was fully documented throughout the entire event. The combination of fear, repeated air raid sirens, mental and physical stress, and staying in a protected space evidently increased vagal tone and caused him to collapse (syncope)."

Hillel Yaffe Medical Center’s Cardiology Division Director, Prof. Ariel Roguin, points to fthe flatline on the ECG

"This is the first documented case in medical literature of loss of consciousness directly caused by an air raid siren," stated Prof. Ariel Roguin, Cardiology Division Director at Hillel Yaffe Medical Center. "It confirms the assertion that there are indirect cardiovascular risks from the state of war we are in and the dangers it poses to cardiac patients, but not only them."

The description of the unique case, which was recently published in the Israel Medical Association Journal (IMAJ), was co-authored by Dr. Polman and Prof. Roguin, along with Dr. Maggie Barel, Cardiac Intensive Care Unit Director at Hillel Yaffe.

The incident took place in October 2024. The patient was kept for continued monitoring, and after discussion, a pacemaker was implanted to provide preventive measures against another cardiac event, if necessary – and hopefully it won't be. He was discharged home in stable and good condition.