False start for this nonagenarian. Coming to assist a woman suffering from chest pain, a SAMU team witnessed a scene as disturbing as it was exceptional: a patient declared dead, without breathing or apparent cardiac activity, “returned” spontaneously a few minutes later. A look back at a medical case that is as fascinating as it is a little frightening.
A flat line on the ECG screen
The story, reported in detail by The Worldbegins in a senior residence where the woman lives independently. Feeling severe pain in her chest, she called for help herself. When they arrive, the patient is conscious, her blood pressure is stable. But the electrocardiogram revealed worrying signs suggestive of acute cardiac distress, compatible with a myocardial infarction. An ambulance evacuation is decided.
When the SAMU team arrives, the situation deteriorates suddenly. The patient loses consciousness, her heart rate drops, then the ECG shows a flat line. She’s not breathing anymore. The diagnosis is that of cardiac arrest. However, his medical file clearly mentions his refusal of any resuscitation. No cardiac massage or electric shock is therefore undertaken. For the team, the outcome is in no doubt.
Back among us
A few minutes later, as the doctor prepares to write the death certificate, a detail troubles the caregivers: the scope shows unusual activity. A clinical verification is required. And then, the unthinkable happens: a pulse is again perceptible in the carotid artery. Then breathing resumes.
Gradually, vital constants return to normal values. The heart rate reaches 90 beats per minute, blood pressure stabilizes, breathing becomes regular, and oxygen saturation is excellent, without assistance. At first convinced that they were witnessing a simple terminal burst, the team nevertheless noted that the patient’s condition continued to improve. Forty minutes later, she regained consciousness.
The treatment then resumes its course. Taken to hospital, an angiogram revealed lesions in two coronary arteries. Two stents were successfully placed. The patient will then leave intensive care for a rehabilitation unit, fully aware of what she describes as a second chance.
The Lazarus phenomenon, a confusing return to life
This type of spontaneous return of circulation after a cardiac arrest has a name: the Lazarus phenomenon. A biblical reference to Lazarus of Bethany, whom Jesus resurrected four days after his death, explaining that he was only “asleep”. In medicine, this term refers to these extremely rare situations where a patient presents a return of vital functions after having been considered deceased.
In the majority of cases described, cardiac recovery occurs within the minutes following arrest and may be accompanied by a state of deep coma. The phenomenon remains poorly understood and continues to question the medical community.
Extremely rare cases, but documented
For Dr Gérald Kierzek, emergency doctor, these are exceptional situations. “These are extremely rare cases“, he underlines, recalling that certain contexts can mislead the clinical assessment: extreme bradycardia, drug poisoning, or even severe hypothermia. In these states, the heart rate and breathing can become almost imperceptible, giving the illusion of death.
But if the case is impressive, it is not isolated. In recent years, several similar episodes have been reported around the world: a woman declared dead who wakes up in her coffin in the Czech Republic, a man in India regaining consciousness in the ambulance taking him to his cremation, or even, in France, a garbage collector waking up in a body bag in 2022.
A delicate diagnosis, based on a bundle of clues
“The diagnosis of death is clinical, almost empirical”, recalls Dr. Kierzek. Unlike other medical diagnoses, it is not based on a single additional examination, but on a set of consistent signs: absence of pulse, breathing and cardiac electrical activity. In extreme situations, these signs can be temporarily undetectable, exposing – very rarely – to errors.
Fortunately, these “returns to life” remain exceptional. But they are a reminder of how the line between life and death can sometimes be more blurred than we imagine.
Without calling medical protocols into question, this episode reminds us that emergency decisions are sometimes based on imperfect criteria. Even if it is very supervised, medicine cannot always predict everything: the human body retains an element of the unpredictable, capable, in very rare cases, of thwarting all predictions.