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Heart Disease (Expert Forum)
An 18 year old's death
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An 18 year old's death
by Chuck, Oct 31, 1999 12:00AM
Recently, at our church, an 18 year African American male died in our gym playing basketball. Emergency CPR was performed on the individual until paramedics arrived, working on the person for 15 minutes or more, and then he was rushed to the hospital to be worked on and then later be pronounced dead. Having received information from the family, we were told the 18 year old did not have a "heart attack." That the person had cardiac myopathy (a heart muscle disease, the heart muscle was diseased), an enlarged heart (with heavy "lungs"?), mitro valve prolapse (which we were told is deadly in itself), and a fatal arrythmia (which is what I think we were told he died of.
We were told that it was genetic/hereditary, but not congenital. I didn't know there was a difference. Could you explain the difference. Also, we were told the physical exertion of the basketball playing brought about the fatal arrythmia (though he has played all year, sometimes harder). And, we were told in this past year a couple pro BB players had died from this same thing. Also, we were told taht African American males are really at risk in this area. We were also told that this 18 year old was the healthiest individual the coroner had seen for a while. That they were surprised at his fitness, having this.
Several of us who were involved in the night, particularly some of us who attempted CPR on him (though not trained and certified, we believe and later were told that we seemed to do it correctly...just with no response) are wondering if a person with this condition and 'attack' could have been resuscitated by CPR. From the time the person hit the ground we were surrounding him checking pulse and breathing. He took several (10+) deep sucking breaths, 10-15 seconds apart. But when the breathing stopped and a pulse could not be found, we began CPR. 911 had already been called. Within minutes (we really believe it was less than 5--they're just down the street a few blocks) the paramedics took our place and tried "everything." After CPR by them, they rushed him to the ER. But again, no rythm nor breathing on his own. We are wondering why nothing helped. Is this type of arrythmia or mitro valve prolapse or cardiac myopathy beyond CPR's help? What happened that the incident took place right there and then? Could it have happened at anytime prior or later? And, if enlarged, and if diseased, and arrythmic, why was nothing ever detected by this 18 year old or his doctors?
I know this is a lot of questions. But, if you can help us understand any of this, it certainly would be help to us. Thanks you!
We were told that it was genetic/hereditary, but not congenital. I didn't know there was a difference. Could you explain the difference. Also, we were told the physical exertion of the basketball playing brought about the fatal arrythmia (though he has played all year, sometimes harder). And, we were told in this past year a couple pro BB players had died from this same thing. Also, we were told taht African American males are really at risk in this area. We were also told that this 18 year old was the healthiest individual the coroner had seen for a while. That they were surprised at his fitness, having this.
Several of us who were involved in the night, particularly some of us who attempted CPR on him (though not trained and certified, we believe and later were told that we seemed to do it correctly...just with no response) are wondering if a person with this condition and 'attack' could have been resuscitated by CPR. From the time the person hit the ground we were surrounding him checking pulse and breathing. He took several (10+) deep sucking breaths, 10-15 seconds apart. But when the breathing stopped and a pulse could not be found, we began CPR. 911 had already been called. Within minutes (we really believe it was less than 5--they're just down the street a few blocks) the paramedics took our place and tried "everything." After CPR by them, they rushed him to the ER. But again, no rythm nor breathing on his own. We are wondering why nothing helped. Is this type of arrythmia or mitro valve prolapse or cardiac myopathy beyond CPR's help? What happened that the incident took place right there and then? Could it have happened at anytime prior or later? And, if enlarged, and if diseased, and arrythmic, why was nothing ever detected by this 18 year old or his doctors?
I know this is a lot of questions. But, if you can help us understand any of this, it certainly would be help to us. Thanks you!
Doctor's Answer
by Cleveland Clinic, MD, Nov 01, 1999 12:00AM
, Nov 01, 1999 12:00AM
Dear Chuck,
A tragic story and fortunately one that is relatively rare. I am sure it has left many of you involved asking many "what if..." questions. The type of condition your friend had is called Hypertrophic Obstructive Cardiomyopathy or HOCM for short. This is a genetic defect (congenital is another term for genetic) and leads to a thickening of the ventricle and an increased risk of ventricular tachycardia, particularlly during intense physical exertion. Had this been discovered earlier his doctor would have restricted him from physical activities but this is no guarantee of freedom from ventricular tachycardia. It sounds like everything that could be done was done and nothing else could have been done differently. My condolences to the family and all involved in this situation.
A tragic story and fortunately one that is relatively rare. I am sure it has left many of you involved asking many "what if..." questions. The type of condition your friend had is called Hypertrophic Obstructive Cardiomyopathy or HOCM for short. This is a genetic defect (congenital is another term for genetic) and leads to a thickening of the ventricle and an increased risk of ventricular tachycardia, particularlly during intense physical exertion. Had this been discovered earlier his doctor would have restricted him from physical activities but this is no guarantee of freedom from ventricular tachycardia. It sounds like everything that could be done was done and nothing else could have been done differently. My condolences to the family and all involved in this situation.
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bradycardia (6 replies):My son is 13 5-3" 118lbs. Very Athletic plays all sports...[more]
My condolences go out to you for your loss.
I have a comment concerning the mitral valve prolapse. I have this condition and I am 18 years old, in fact, many people do. The condition is very common, I have had it since I was born. I know that it can sometimes cause problems, but in the worst case that would be a valve replacement(from my understanding). I would think that it was a genetic defect, or a combination of all those problems together that lead to his death. Although I am not a doctor, I have done a lot of reasearch on MVP and I could never find any links between that and death. If there are any comments from anyone else who knows anything more, I would appreciate them and I'm sure Chuck would.
Sudden unexplained death in young people (common in athletes) is often associated with
a prolonged QT interval. I have this and have nearly died six times from cardiac arrest.
The condition is typically inherited, although certain drugs and eloctrolyte abnormalities
can prolong the QT interval also. It is not a real common condition, although it is the
a major cause of sudden death in children and teenagers. Sudden death occurs frequently
during exercise, but can also occur during sleep, a startle (such as a loud noise)
or during normal activities. My cardiac arrests have almost always happened while at rest.
This can be easily diagnosed with an EKG, and sometimes a stress test. It is usually easily
treatable with beta-blockers and in a few instances a pacemaker is required. I also have
gastroparesis (a paralyzed stomach) so my cardiac arrest are often the result of low potassium
which I have a heck of a time keeping up. If you have any more questions about this, feel free
to e-mail me at ***@****. Good Luck.
I was reading your letters and was wondering if someone could help me with my recent questions.
My year round 12 yr. old son who recently had surgery to have an extra navicular bone in his foot removed was well post op for 3 weeks until he started having near fainting spells, daily nausea, and daily headaches, fatigue, and several episodes of chest pain, and a feeling of his heart racing. He gets very pale when this happens.
He's been to the doc several times, and just went to a peds cardiologist, who said he had a normal EKG, and ultrasound. He will have a halter moniter next week. He was diagnosed with mild mitro valve prolapse, but not necessarily the problem, according to the doctor. So far, we don't have an answer to what's going on, he's due to follow up with his doc next week, and I'm confused still.
Any Help out there?