Posted on 06/17/2008 6:03:22 PM PDT by neverdem
Given the great strides that have been made in preventing and treating heart disease, what explains Tim Russert’s sudden death last week at 58 from a heart attack?
The answer, at least in part, is that although doctors knew that Mr. Russert, the longtime moderator of “Meet the Press” on NBC, had coronary artery disease and were treating him for it, they did not realize how severe the disease was because he did not have chest pain or other telltale symptoms that would have justified the kind of invasive tests needed to make a definitive diagnosis. In that sense, his case was sadly typical: more than 50 percent of all men who die of coronary heart disease have no previous symptoms, the American Heart Association says.
It is not clear whether Mr. Russert’s death could have been prevented. He was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight, his doctors said on Monday. And still it was not enough.
If there is any lesson in his death, his doctors said, it is a reminder that heart disease can be silent, and that people, especially...
--snip--
Even so, Dr. Newman said, “the autopsy findings were a surprise.”
In an interview, Dr. Newman and Mr. Russert’s cardiologist, Dr. George Bren, said the autopsy found significant blockages in several coronary arteries, which feed blood to the heart muscle.
Blockages start out as cholesterol deposits in the artery walls that turn into lesions or plaques, narrowing the vessels. Heart attacks occur when a plaque ruptures, causing a blood clot that quickly closes the artery and pinches off the blood supply to part of the heart...
(Excerpt) Read more at nytimes.com ...
Common people die in this manner every day. No one seemed too concerned about answers for them.
Some cardiologists say a thickened or enlarged heart can indicate severe heart disease and should prompt more tests, like an angiogram, to look for artery blockages. But those tests are invasive, and Mr. Russert’s doctors did not think he needed them.
Had the tests been done and the true extent of blockages revealed, Dr. Newman said, Mr. Russert would probably have been advised to have bypass surgery. Dr. Bren differed, saying it was not clear that there was enough disease to prompt a recommendation for surgery.
Who would think that someone as famous as Tim Russert wouldn't have these tests if doctor's had any suspicion what-so-ever about his heart health...
Forget doctors, angioplasties and statin drugs. What killed Tim Russert was his endless up and down dieting. Nothing causes more stress on the heart than gaining and losing weight through obsessive dieting.
The media really loves to dwell on the passing of anyone famous in their own profession.
They really think that their job is the most important, and the passing of a Tim Russert just can’t have enough coverage. We have to hear about his life, his disease, his son, we have to hear from all of his colleagues, all of the people he interviewed, etc., etc.
They’ve spent more time on him than they did on the passing of Ronald Reagan. And Tim Russert was not Ronald Reagan. Except in the minds of journalists.
Thanks for the feedback. That chest pain was your first symptom.
Russert was looking awful for the last few year’s. Puffy and expressionless in the eyes. His primary Dr. made a huge mistake not to request angiogram. That would have shown the artery problem and he would have been asap for bypass surgery.
I speak with some knowledge. Husband had no symptoms. Annual physical Dr said you have never had a stress test, let’s do that and see how you are doing. Took stress test and didn’t do well. Went for angiogram and bingo three clogged arteries. Had triple bypass surgery and all is well.
Rich, famous, stressed out, and unhealthy. The Elvis Presley syndrome. Man, if I were ___________ , I’d take the money and quit the rat race.
Who pays for autopsies, anyway?
Ahh, ventricular fib. Same thing happened to my dad. From what I understand, you're gone within ten seconds, no amount of CPR or anything can save you. You're done.
I don't know. My guess is the taxpayer when it is demanded by the state. Someone may pay for it if it is optional. I don't see how pathologists can make a living doing freebies. I saw only one autopsy that I recall as a medical student, nothing since.
Healthcare is driven by “best practices”, formally known as “cookbook medicine”.
Heart blockage tests are expensive and invasive, so most docs don’t recommend them unless there are hard, clear signs. However, people who are worried about heritity or just a gut feeling can pay for a heart test at their own expense under our current system. David Letterman did, and they scheduled surgery for the next day. Unfortunately, in some countries with national plans, you can’t do this.
BTW, much of the savings the government figures will come from national health care will come from using “cookbook medicine” for everyone.
I can relate. I was in ICU recovering from quadruple bypass on Friday when the announcement of Mr. Russert’s untimely death came over the TV screen.
No symptoms, 63 years old, normal cholesterol, type 2 diabetic and just blacked out after exercise on a treadmill. In the netherworld for about 20 minutes according to wife.
Brain scans, carotid artery tests, echocardiagram of heart, more MRIs of brain and then a nuclear stress test. Blockage noted (90% in couple areas and 75% in couple of others) and was in surgery 6/12. The cardiologist was very, very upfront and I am so glad he was. Home recovering nicely but if no nuclear stress test, no Chuck54.
I didn’t even know who to spell cardiologist until last Wednesday, now I know a great one. Saved my life I truly believe.
Do CPR until a defibrillator is available. Keep blood going to the head. It depends on whom the patient is, a young, otherwise healthy trauma victim or an elderly patient with multiple medical problems. If the former, be aggressive. If the latter, don't knock yourself out, especially if they were resuscitated already.
Almost forgot but the heart cath was done after the nuclear stress test and this was the golden test.
Blockage showed up immediately.
Heart caths are a bit uncomfortable but the alternative is quite permanent.
Cornary CT angiography would have simply and noninvasively diagnosed Russert’s heart disease and provoked a more intensive treatment regimen. However, medicare and the private insurers don’t won’t to pay for the procedure (cost about $1000).
Coronary CTA is being strangled in its crib. Welcome to the world of health care rationing. It will only get worse with Obama.
Can either of you recommend tests that discover blockage, etc early? I’m 40 1/2. I hate to say, but I’m a good candidate for heart disease. Family history, ex cig smoker, I still smoke cigars. Anyway, I really like being alive and want to try to eek out another 20 yrs if the Lord will allow. So if you have any good advice and the time to tell, I’d appreciate it.
Maybe that's the answer I'm looking for. I wonder if you lie and complain of chest pain if you can get insurance to pay. I would love to get my arteries checked out from time to time. I'm 40 and starting to face the risks associated with getting older. I want to live another 20 yrs if possible. Don't want to miss an opportunity to dodge a bullet.
High triglicerides and low HDL. I think we are seeing this picture become much clearer. And a thickening of the heart muscle is not good. Personally, I think someone was asleep at the switch.
Russert’s death was preventable.
I am very glad to hear that. I wish you and your husband a long and healthy life.
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