Swift action taken by an alert passer-by and a medical team at the National Heart Centre Singapore saved the life of a 71-year-old man within 24 hours of his arrival in Singapore.
British engineer Ian Scott was on the brink of death from a rare heart emergency in which a tear along the inside of the major artery caused blood to gush in between the vessel's walls, splitting the layers apart.
The pressure of the leaking blood even stopped his heart.
He had collapsed by the road outside his hotel in Chinatown, but was spotted by a man who rushed to his aid and called for an ambulance.
At the hospital, a team led by Dr Soon Jia Lin did a seven-hour overnight operation to patch him up.
They replaced the affected portion of the artery, and fixed a leaky valve.
It was a "huge" operation, akin to a "major plumbing work", said Dr Soon, a consultant in cardiothoracic surgery.
"His body was cooled to 18 deg C to preserve heart and brain function. After that, all blood circulation in the patient's body was stopped to facilitate the repair work," he added.
Mr Scott's medical condition, called aortic dissection, occurs in only two to five out of 100,000 people worldwide. It involves a tear along the inner walls of the major artery that carries blood out of the heart, called the aorta.
The risk of death goes up 1 per cent every hour the rupture is left untreated. Half of those who suffer it die in 48 hours.
In fact, Mr Scott's heart had stopped minutes after he was wheeled into the operating theatre, said Dr Soon.
Blood had leaked into the sac that surrounds the heart. The force pressing on the organ grew so strong that it could no longer pump blood around the body.
After a month and a half in hospital, Mr Scott is well enough to travel home to England this week.
Speaking to The Straits Times before his flight on Tuesday, he said he was looking forward to celebrating Christmas with his family in Sunderland.
"I was bored to death being in the hospital," joked the father of two grown-up sons. "I thought of my family all the time."
Hypertension is the main risk factor for aortic dissection, said Dr Soon, advising people with the condition to adhere to their medication that keeps blood pressure under control.
The National Heart Centre Singapore treats about 20 cases with the condition a year. Fewer than 10 per cent end up in a "near death" state, like Mr Scott.
The 30-year-old Good Samaritan, who wanted to be known only as Mr Boo, said he was in a shop in Chinatown when he spotted the elderly man outside, shaking vigorously and slowly sliding to the ground.
Mr Scott wrote a thank-you note to the self-employed man although he remembers little of the roadside collapse.
The engineer came to Singapore to fix a hydraulic machine but the project was delayed by the incident.
He has to move around in a wheelchair for the next three weeks but he declared: "I will be back to finish the job."
