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 ...
It is actually supposed to be quite an aid to people with digestion problems. If you start off with a small amount, you can up the amount you take over time.
If you can’t tolerate it orally, I think you can get topical creams that have it in.
In the midst of life we are in death; of whom may we seek for succour, but of thee, O Lord, who for our sins art justly displeased?
-ccm
With all due respect, I was asked what I thought about it in comment# 50. The abstract for the link I provided didn't strike me as a glowing endorsement for screening from a recent paper.
my husband had a 64-slice CT scan a month after his younger 46-year old brother died of a heart attack... i wonder if Tim Russert had one done... if not, i wonder why... even if one has no insurance, it’s not that expensive... it’s especially worth it if one is high risk...
Test nearly lethal, veteran says - Anti-smoking medication linked to psychotic, suicidal episodes
FReepmail me if you want on or off my health and science ping list.
I’ve seen some patients who just don’t fit the profile, with normal cholesterol, active lifestyles, non-smokers, etc., and have begun to wonder about some connection with a flare of inflammation due to stress, injury or infection.
My 72 year old daddy had an incidental finding of a 6 cm abdominal aortic aneurysm, which led to a heart cath showing single blood vessel disease with 90% occlusion in the Right coronary. Daddy smoked 3-4 packs a day for 60 years - still about 1/2 to 1 ppd, on and off. (Even an aortic aneurysm repair and a new bride won’t deter him for long.)
God bless and speedy recovery! (Do what the docs - or at least your wife - tell you to do, okay?)
Interesting, after reading all comments there is no mention of what type of food he ate or how he managed his stress levels of his intense lifestyle, as possible contributing factors. This is discussed extensively in other blogs.
Russert is, unfortunately, a primae facie example of the shortcomings of modern medicine, and it should well give people cause to question. Freepers are generally uninformed about the burgeoning alternatives to the medical model.
Can everyone request an autopsy? If the authorities won’t pay for it how much do they cost on a private pay basis?
Thanks hocndoc.
I had a pretty good night, slept pretty sound, and feel stronger every day.
Life’s good.
:)
I agree VOA that is a sad situation. Just think of the thousands every day who do not take the small symptoms serious, do not have the very concerned family such as yours, and die lonely and alone.
Your dad seemed from the “old school”, as well as mine was and just didn’t want to be a bother to anyone.
They are missed greatly but the memories are forever.
My nurse friend asserts that
ROYAL ARTERIAL FLUSH
is for real and really effective.
I don’t have a link handy.
LOL on the state pride. Glad everything worked out for you.
Thanks so much for your service!
Now here's another question: If the CT Russert had showed a moderate to high risk of heart attack from the amount of calcified plaque in the arteries - shouldn't a conscientious MD have ordered the CT angiogram (to look for the soft plaque you described), and possibly other more involved tests to determine if Russert was a walking time bomb? Or am I again confused by thinking that the CTA shows soft plaque?
There will be lots of second guessing. Coronary CTA is relatively new. It requires the latest greatest CT scanners to visualize the coronary arteries adequately. Many (most) physicians don't know much about it. Some cardiologists have not embraced the technology since they don't perform the test and it undermines tests that their business model relies on.
Coronary CTA has its limitations and you do receive a slug of radiation (although not much more than any other ct of the body). To learn more google coronary cta and or Dr. David Dowe. He's performed over 5000 coronary ct's and is a true expert.
Going to the cath lab would be the best thing, but we can’t test every person this way and there could be serious complications from the test it self. Right now the best thing is a resting EKG, stress test, and a normal and stress echo. If these are normal and you have a negative family history you are pretty safe, but there will still be some people who pass every test and still get sick.
Not really sure where there’s a surprise. He was an overweight guy and according to Michael Wilbon just a few months ago (after Wilbon had a heart attack) they had a long discussion about life and heart troubles and work, and Russert specifically mentioned how he doesn’t eat right during election years because he’s so busy. Seems to me that’s the answer.
Obviously, it's not. But it is a learning opportunity. We don't know what we don't know. You have to figure out the right question first. Sometimes you find it serendipitously. Others, it's a laborious trial and error. But you can't find it if you don't look.
Seek and you shall find.
If the authorities won’t pay for it how much do they cost on a private pay basis?
I have no idea.
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