Did my dad's doctor miss something?

[arte73]

My dad died on November 1, 2011 at age 70 of what we believe was sudden cardiac death (an autopsy wasn't performed).  He was giving a speech to a home owners association and fell over unconscious.  CPR was administered immediately, but he never regained a pulse or was able to breath on his own.  He was transported to the ER, where the worked on him for 30 minutes before pronouncing him.  At the ER his heart was asystole and his abdomen was distended.  The ER doctor said they were never able to get his heart started again and he never had a pulse.  He said he died of cardiac arrest.

In October 2011 my dad had a full physical, stress test, ECG, EKG, Bruce, Holter Monitor, and Echocardiogram (my dad had cholesterol screened 4x/year and did annual physical/heart tests--was very religious about it).  The doctor's only recommendation for my dad after the physical was that he continue his meds (lipitor 40mg, norvasc 5mg, and 324mg aspirin) and lose 6lbs.  After my dad died my family and I asked to speak with the doctor (a general physician), because it didn't make sense that my dad died--we all thought he was in great health.  When we spoke with the doctor, he said that given my dad's history (heart attach at age 48 and quadruple bypass at age 49) his heart was a ticking time bomb and that he was fortunate to have lived as long as he did.  He said my dad died from either the dysrhythmia or from a blood clot in his heart.  This made us angry because we felt my dad's doctor didn't provide the best care for my dad and led him to believe that he was in good health.  We requested my dad's records the next day, here are some of the findings.

1. My dad was diagnosed with a cardiac dysrhythmia in June 2010 that was untreated.
2. My dad had a quadruple bypass surgery in 1990.  From what I’ve read, the longevity for bypass surgery is 10-15 years.  Other than Lipitor, blood pressure medication, and aspirin, there was no mention of any other treatment.  The doctor did prescribe amlodipine besylate in October 2011, a month before my dad’s death.  
3. The ejection fraction for my dad’s heart declined from 52% in November 2006 to 34% in August 2011.  
4. My dad’s heart was damaged from a heart attack he suffered in 1989, which is noted by the old inferior infarct.  This is mentioned throughout my dad’s records.  There is also mention of an old anterior infarct in my dad’s records in August 16, 2011 (shown on ECG) and a possible anterior infarct in my dad’s record in April 26, 2005 (also shown on ECG).  My concern is that because my dad’s ECG always came up as abnormal and that he might have suffered a mild heart attack (anterior infarct) that was described as old when it could have been new.
5. My dad complained of shortness of breath on his last stress test in August 2011.  The stress test also showed that my dad's heart exhibited PVCs during the stress test.  
6. The impressions of the heart scan in August 2011 and August 2010 showed evidence of abnormal wall motion with global hypokinesis and also showed evidence of “moderate probability of ischemia).
7.             My dad complained of pain in the right side of his chest when laying down 6 months before his death.
8.             My dad had erectile dysfunction (which I understand can be a result of poor blood flow) diagnosed in 2009.

My dad had been seeing the same doctor since 2005.  After speaking with the doctor and reviewing my dad's records, I feel that his doctor missed something or should have prescribed alternate tests/treatments for my dad.  We asked him why he didn't and he said that insurance wouldn't have paid for it.  We asked him why he didn't refer my dad to a cardiologist, he said my dad declined.  I've looked through my dad's records, there is no talk of referring my dad to a cardiologist or my dad declining to go.  Bottom line, I think the doctor is trying to cover his butt.  I think he messed up big time in taking care of my dad.  Appreciate a review and feedback of my dad's situation.  Thanks.

[grendslori]

I'm sorry that you lost your father this way; my father died suddenly as well, from a ruptured left ventricle. The chances are not too high of this being a blood clot with your father if he was taking asprin; that is used as a blood thinner. More than likely he died as a result of a ventricular arrhythmia. That type of arrhythmia causes a sudden death event and it needs to be converted almost immediately in order to save a life. There's always the famous story of the person leaving the doctor's office with a clean bill of health and dropping dead leaving the office. Your father had good health follow up care with all of the testing he was having done; the only test I could see that may have helped would have been an EP Study which is a study that looks at the electrical system of the heart; the problem is that if the electrical system of the heart that works it's way into a full blown arrhythmia was not actively charged and active on the day of the study, nothing would have been found and you would have been back at square one again. Your family has had a loss and understandably, you are all angry....we always want to find someone to blame when things go wrong, but I can see no blame in the things that you have written here. You and your family need the time to heal; focus on his life and the things he has given to you in the man that he was and understand that, God willing, you will see him again someday. Take care    

[Red_Star]

Doctors are the third leading cause of death in the US. 106 000 people die every year taking the drug as the doctor directed.  Statin drugs deplete CoQ10 (known since 1985!), vitamin B12, folic acid, vitamin E.  Aspirin depletes folic acid.

When CoQ10 is too low this leads to congestive heart failure or heart attack to name but two symptoms. Vitamin E is called the sex vitamin and sexual dysfunction is a symptom of this deficiency. One study showed that the risk of a fatal heart attack increased 4 fold in those with high homocysteine levels in the blood.  The top three nutrients to keep homocysteine levels low are vitamin B12, vitamin B9 (folic acid), and vitamin B6.