Abstract

Cardiovascular diseases remain the leading cause of mortality worldwide, with ST-Elevation Myocardial Infarction (STEMI) requiring urgent intervention to restore coronary blood flow and prevent irreversible myocardial damage. Percutaneous Coronary Intervention (PCI) is the preferred method of myocardial revascularization and the standard treatment for STEMI. Procedural failure may occur, necessitating repeat interventions that can result significant emotional and financial burdens on patients and their families. While existing literature has largely focused on clinical outcomes such as procedural success and survival, limited attention has been given to the psychosocial and economic consequences of repeated PCI procedures, particularly in low-resource settings such as Kenya. This study explored the emotional and financial trauma experienced by a patient and his family following repeated PCI procedures after an initial failed intervention. A descriptive sample case study design was employed involving a 73-year-old male patient diagnosed with STEMI at a Kenyan referral hospital. Following failure of the initial PCI, the patient underwent two additional PCI procedures. Data were collected from clinical records, laboratory findings, procedural reports, and narrative accounts from the patient and family members. Thematic analysis was used to identify key themes related to emotional experiences, caregiver burden, and financial implications associated with the repeated interventions. The findings revealed considerable emotional distress affecting both the patient and his family. Following an intra-procedural cardiac arrest during the first PCI attempt, the patient experienced fear, anxiety, helplessness, and emotional instability. Family members reported persistent worry, sleep disturbances, emotional exhaustion, and uncertainty regarding the patient’s survival and recovery. These experiences highlight the profound psychosocial impact of repeated cardiac interventions beyond the immediate clinical outcome. The total hospital bill amounted to KES 882,701, leaving an out-of-pocket deficit of approximately KES 300,000 despite partial insurance coverage. To meet these costs, the family organized multiple fundraising efforts (harambees), depleted personal savings, and experienced income loss due to caregiving responsibilities. The resulting financial strain affected household stability and overall family well-being. Psychological distress associated with repeated invasive procedures was compounded by substantial economic hardship, creating a cyclical burden that negatively influenced patient recovery and family welfare
Key Words: Percutaneous Coronary Intervention (PCI), ST-Elevation Myocardial Infarction (STEMI), Emotional Trauma, Financial Toxicity, Caregiver Burden

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