death

[momule]

I am writing because of the death of my 39 yr old son from dilated cardiomyopathy(biventricular dilation) per coroner
heart weight @ death 440 grams, no congenital malformations, valves of normal size, ventricles of normal dimensions, but both dilated....no artherosclerosis, aorta free of lesions and normal, vena cava and tributaries are not remarkable........lungs, no lesions(rght weighs510 grams, lft weighs450 grams) pulmonary arteries are free of thrombi and bronchial tree is clean.....Dec 6 2000

upon recieving my sons medical records, here is the finding on oct 18 2000......."no" heart enlargement.........He presented  @ the emerg room with moderately severe chest pains and both arms hurting...arms tingling, nausea, vomiting, shortness of breath,  sweating, palpitations.......
no edema, or syncope......cardiac protocol was performed....

Echo, ekg, monitor for 24 hrs was done...LV EF was 61%, Bp 160/92
which came down with iv and lopressor, sodium, and aspirin.....
anyway, no active disease, lungs clear, no evidence of infiltrate

4 physicians attended or read records and comments which i am still trying to decipher.......I am sorry this is so long, he was sent home with 800 mg of ibuphrophen 3 times a day for 10 days,
and after 10 days another prescription of same.........he was told to quit smoking and not to drink.......he had lifted a roll of coiled steel in sept and had been hurting ever since to one degree or another, but no lesions or tears were found by dr or coroner.......what am i missing?.......how could heart go from "no " enlargement to 440 grams in 6weeks and produce death in fibrillation?......coroner said we wouldd have had to have been standing there with the paddles to save him(he lived alone)....
thank you for your time

[nettiespaghetti]

A related discussion, prognosis for v-tach bigeminy with viral cardiomyopathy was started.

[BJP]

I am so sorry about the loss of your son. I want to express my deepest sympathy to you and your family. My father died at 40 after having 8 heart attacks for virtually no reason from the age of 26. My mother passed away at 69 but had a pacer and died of V-fib and had a few strokes becauseof a abalated uncontrollable A-Fib. My dads brother also died young at 41 from a heart attack. I live in extreme fear from this and I do know that my father had very simaler episodes as your son did and they did say heart attack. He also had dialated cardiomyopaty from this.  Again my prayers go out to you and yours...God Bless

[momule]

....thank you all for staying with me on this and all your responses, even though we don't have a clue of why the heart enlarged in so short a time, and it really is a mystery.....
considering LTQS, the pain from lifting and making him nauseated
from the pain on little exertion, the electrolyte imbalance(even though he had been drinking lots of juices, maybe too much)probably contributed to his death....it just is amazing that none of us really had a clue of something so serious.....
GOD bless to all.....the report that Mike posted on PVC thread right above this one, from 1949, helped a whole bunch....

[momule]

O.k....I hope you all are still with me.....I finally recieved the med reports back.....

my son was escorted by ambulance and paddles were used @ 5:30p.m.
the first ekg was @ 5:54....rythym analysis@ 5:43
this is the reading of the firts ekg:
pr  139 *sinus tachycardia @ 105 bpm
qrsd  107 *incomplete right bundle branch block
qt    358  qt interval long for rate
qtc  473 *no prvious tracing avail. for comparison
--axes--
p  61
qrs  81
t 53

second ekg @ 8:44 p.m.
pr  145  *normal sinus rythym @ 69 bpm
qrsd  102 *incomplete right bundle branch block
qt  415  *consider early repolarization
qtc  445 *compared to prior the rate is slower
--axes--
p 32
qrs 56
t 47

3rd ekg 7:19 a.m. next day

pr 149 *sinus rythym @67 bpm
qrsd  101 *incomplete right bundle branch block
qt  401  *nonspecific j point elevation, consider early repolarization
qtc  423 *compared to prior ekg, no significant change
--axes--
p  30
qrs  58
t  46

so I still don't know if he had a heart attack or "just"
irregular" heart  and low potassium which blood test indicate and no enlargement.......can long qt inflate the heart in a short time? or low potassium?....i found a site on a viral heart(picture) from a pathology site and think the coroner would have picked up on it or maybe would have know if he was ill in that 6 weeks time frame.....thank you for listening

[momule]

janice:...i sent you a private e-mail and thank you for your comments...
i have not responded to this thread, because I still do not have my medical and coroners report back from my daughter-in-law.....she took them yesterday to my other sons dr. with him in tow and thats where we are now.....so I will keep you posted later......GOD bless to all

[janicemomof2]

you are right in researching LQTS--low electolytes and especially a potassium deficiency can cause a prolonged Q-T interval, often suddenly with no prior ECG markers, as evidenced by recovered anorexics/bulimics, who sometimes can die suddenly for no apparent reason (think Karen Carpenter). Amitryptilene (sp) can cause or worsen q-t interval also.  As to the sudden heart enlargement, one person brought up viral cardiomyopathy, which is still a valid question since you said the autopsy showed no BACTERIA. Viruses are not bacteria. Another possibility is if he ever had rheumatic fever, especially as a child. Still another possibility is a grossly raised blood pressure over a short period of time--this is the cause of enlarging or hardening of the heart in many otherwise healthy people especially women (pre-ecclampsia and toxemia can cause this to occur in pregnant women FYI)
I am 26 years old, I have LQT but it does not show up on a normal ECG for me. I have had many symptoms and it has been a fight to get a proper dignosis and proper treatment.
I don't come online very often, so if you want to reply or just talk about your "baby" boy, email me at ***@****  or ***@****
I am so sorry for your loss. I have 2 children, ages 11 and 10 and the thought of losing them, when 'doctors don't know why' enrages me.

Jan

[CCF-M.D.-DLB]

I am sorry to hear about your son. It sounds like he died from an arrhythmia due to dilated cardiomyopathy, possibly from a viral infection. I agree with the coroner that there is nothing that you, your son or your doctors could have done differently to prevent this tragedy.

[momule]

thank you for posting the info on LQTS.....I was unable to really read the ekg stuff correctly and probably what i posted was incorrect.....i will post accurately, after sun, because my daughter-in-law took home with her to make copy and wont be back till sometime sun....apparently no one can still geve me an
answer of what could cause the heart to enlarge in so short a time, or maybe it is unanswerable......i am trying very hard to come to closure on this and have searched many hours for answers, and had to read many definitions and did a whole lot of praying to understand all of them.........all of your comments are appreciated more than you will ever know and my heart and prayers go out to each of you....maybe a good dr. will pick this up and give some insight on heart enlargement and i will post ekg
info after tomorrow....GOD bless each of you

[momule]

Hankstar: thanks, but the autopsy performed was quite intensive and showed no bacterial infection in the blood work up or no congenital abnormalities....i would have thought tha given the food allergies he has had, would have produced something in the lungs or bronchial tree.......I know that all meds he has taken over the years for allergies and anti-depressants and prozac are not good for the heart if there are any abnormalities.....these things he has not taken to my knowledge since 1997...and only used an inhaler when he mowed the yard or got into something that would cause him to wheeze(not very often, because @ his age he mostly knew what would cause him to wheeze)....I know that the coxackie b virus can play havoc with the heart....my grandmother had a heart attack @ 55 yrs old from strep, and never had any more problems after that, lived to 93....my boys were aware of this and took care of infections quickly...thank you so much for your comments and anything you or anyone can offer.....I have been on every pathology site(i think) and heart site, studies ect. and LTQS was the only possibility, I could come up with and the elctrolites(low potassium)...I will have the exact EKG reading later, I can remember, something about re-polarization
in order....but I can't remember without having all in front of me and some is hard to read....I have thought about making an appt with the dr. in a consultation mode, but i am still not in the right frame of mind and don't know the right questions to ask
Thank you......

[momule]

dodgybeats:...thank you so much for your insight and comments....
so sorry for your loss also, seems to be happening quite a bit,
and yes I think it is familial.....i have a copy of the echo
and i do not know how to interpret what i have but from all i have gathered it could be LTQS, possibly.....but still no answers
how the heart could have enlarged so much in 6 weeks or in your case 3 mos......it is strange that my father died @ 38 yrs old of a heart attack and like my son had lifted something heavy(a car engine) and then had a heart attack.....he smoked and did not drink, no autopsy(1949)...and his dad was a baptist preacher
@ age 40....grandads brother was a texas ranger and died on a riverbank fishing of a heart attack @ 55.......none to my knowledge had been ill before........but i have no real way of knowing because no autopsy was performed on anyone other than my son.....my dad and grandad had gone to the hospital and died
within 2 hrs(dad) 3 hrs(grandad).....my great uncle lived with us and was not complaining of anything....so go figure...so i pray someone will answer my question on the heart enlargement or @ least what i can research........GOD BLESS

[momule]

hankstar: thank you for the info and the kind words.....i am dealing with this not very well, because i have another son 37.
He has never had any problems either, and i have 2 grandsons who play in sports, hot and heavy.....so my anguish is for them...I know the mother carries the gene or chromosone, but since i am not a biologist or a dr. I am having to learn about this the long way around.....i know some anti- arrythmic drugs made patients worse, but none of the suspect ones were given to my son and he didn't have any prescription to take home other than ibuphrophen..so i am @ a loss.....as are probably a lot of other people this has happened to.....I don't want this to happen to my
other son or grandsons.......thank all of you for your comments and sharing your pain, for it is truly devastating to not know
or expect something is wrong, I don't believe my son knew any of what i have written or he would not have been so casual about it!
GOD bless all.....

[heartfull]

Hello to all
  I am so sorry to read about the loss of loved ones. I am a 36 year old mother of 2 beautiful daughters, ages 9 & 5. I have idiopathic dialated cardiomyopathy (so they say...the idiopathic part) and i can tell you that in the young, most cardiologist do not pay close enough attention to our symptoms because we are just too young!! I get copies of all my test results myself. My last echo was a little over a year ago and tho my dr. told me everything was going great, my EF had improved by 6 points, when i compared the echo to my previous (6 mos. earlier) my left ventricular chamber had enlarged by 10mm!! There were multi changes in size in all parts of my heart but they mainly use the ejection fraction (EF) as their tell tale. It is so sad that they do this. I am to have another cardiac workup by may and am hoping for some shrinkage. I have also developed v-tach, which has really been going unnoticed by them for a long time. If the size of my heart has increased, I will have to travel out of state to get to the right doctor.
  I DO believe in Christ, He is my rock and having Him in my life has made all the difference in this world to me. I couldnt deal with all this without HIM!! Peace and love to you all this Easter   :-)

[dodgybeats]

I am very sorry to read of the loss of your son.  I lost my brother to idiopathic biventricular dilated cardiomyopathy 9 years ago and it has a been a never ending struggle ever since to try and determine how this condition was not picked up by his Drs.  My brother presented to ER about 1 year before his death with tachycardia (200 beats/min) and extra beats.  he had every single medical test you can imagine including echos.  Everything appeared normal and he was told his condition was essentially benign (his cardiologist said that SVT in healthy young people is almost always benign).  He had a few more episodes of SVT and some chest pain and so was evaluated regularly at one of the top cardiac centres here in Australia, and given Tamboccor which seemed to control the fast heart rate and chest pain.  He had an echo approx. 3months before he died which his Dr said was normal and healthy.  He died on mothers day whilst playing sport - like your son, he died of ventricular fibrillation.  He was 17. I am still at a loss as to why the numerous tests failed to pick up his enlarged heart (it was 500g at autopsy).  It is now acknowleged that approx. 50% of cardiomyopathy cases are familial - this could explain the premature deaths in your family.  If you have any other children/grandchildren please monitor them - I myself am constantly annoying my Drs as I have some symptoms of heart problems myself (I am 29).  Cardiomyopathy is a horrible, mysterious disease which the medical profession readily admits it knows little about.  I guess in some cases (possibly your son's and my brother's) degeneration into heart failure is incredibly rapid and difficult to detect.  I hope that reading about my experience helps you know that you are not alone.  My parents and I are not religeous people but we like to think that my little brother is still here with us -  if only in our thoughts and memories.

[mai_lin]

I'm so sorry to hear of your loss.  It is always sad to hear of people dying so young.

I am 22 years old and have Long QT Syndrome - based on your sons QT interval of .415 (I'm assuming that was resting) he does not have LQTS.

The best discriminator between an LQTS diagnosis and a normal (non-affected) is a QTc (thats the rate corrected QT interval - you can get it off his EKG) of .46 seconds or longer.  Approximately 30% of LQTS patients have a QTc interval shorter than this, and a few percent of normal have a QTc of .45 or .46.  Thererfore, this discriminating point is not completely sensitive nor specific.  A QTc interval of .48 seonds or great in women (mine is .64) and 0.47 seconds or greater in men appears to be nearly diagnostic of LQTS in the absence of drugs or other form of heart disease which might independently lengthen the QT interval.

Long QT is a genetic disorder (my father has it), so if you suspect that Long QT may be the cause of your sons death you NEED to have members of (at least your immediate)your family checked.  A simple EKG should detect Long QT - although some need to have a stress test also.

I'm sorry again to hear of your loss, you will be in my prayers.

Jennifer :o)

[Addie]

My deepest sympathy to you and your family.  Your story hit home.

My father also died at the age of 39.  He had chest pains in Janaury and had a work up and was told to take a few days off.  They thought it was job stress.  In March, while he and I were walking, the pains were horrible.  He died that night at home.

This was years ago and I know if Angiography was available then, my father would most likley had a bypass and not died.

But, today, with so much available for a heart or suspected heart patient, my father's story should be history.  

I too am puzzled about your son.  With chest pain, did they not do a heart catherization to look and see?

God Bless You.  I feel your pain.

[momule]

so sorry also for your dad, mine also died @ 38......of a heart attack, his dad @ 40 of a heart attack.........I am looking for answers, that i don't believe I will find easily......I failed to mention in my previous post that my son also had xantac for anxiety during his 24 hrs in the hospital and when i asked him
what the prognosis was, he only said he had low blood pressure
and no heart attack, an irregular heartbeat and low potassium....

as a baby, he never slept over 4 hrs @ a time and this followed thru to adulthood, he was diagnosed @ 8yrs old as depressed and
hyperactive.....he also had allergies(ocassional asthma from specific foods and cats) over the years he has had torfanil, elavil and tegritol(no longer than 3 mos @ a time)...for allergies he has taken tedral and prednisone, not regularly, only when needed...in 1997 he was diagnosed as bi-polar and had 3 mos of prozac, but didn't like the way it made him feel physically even though mentally it served him well....he took an occasional inhalant when he would get around something he was allergic to(most recent).....He actually was a very healthy individual
always very physical @ work or play and never complained of anything except sleep problems and was tired from lack of sleep
when you asked, but he kept on going and he took a multivitamin
the only other thing is the qt @ 415 which i think is long between heartbeats.......still i question, what would cause the heart to go from "no enlargement" to 440 grams in 6 weeks?......

thanks for your comment