NBC newsman Tim Russert died from a massive heart attack on Friday, reminding a nation of the dangers of heart disease, which can kill without warning and is still a leading cause of death in the United States. The American Heart Association reports that over 300,000 Americans die from sudden cardiac arrest each year, and many of those people don’t realize they’re at risk. Unfortunately — and in a 58-year old male [this] is typical — sudden death may be the first manifestation of underlying heart disease [WebMD].
Russert’s doctor, Michael Newman, says the journalist was being treated for coronary artery disease and took prescription medication to lower his cholesterol, but there were no prior indications that he had reached the end of his days at the age of 58. He was carrying excess weight, Newman observed, but he got regular exercise and he performed well on an exercise stress test in April [The Wall Street Journal].
For middle-aged men such as Russert, the disease usually follows the same progression. It starts when cholesterol plaques build up inside the wall of one of the arteries that brings oxygen-rich blood back to the heart. They can [stay there] for decades until one of them fractures, at which point the body tries to plug the hole with a blood clot—and ends up blocking off the whole blood vessel. This condition is known as a coronary thrombosis, and it is extremely dangerous.
The heart muscle, now starved for oxygen-rich blood, falls out of rhythm; it quivers but doesn’t pump. “In the final stage, the ventricle looks like a bag of worms. It’s chaotically beating very fast and therefore is completely inefficient at pumping blood,” says [cardiologist Jeffrey] Olgin. “Soon, there’s no blood flow anywhere, including the brain, and people just suddenly collapse” [Newsweek].
Russert’s collapse at the NBC studio on Friday was shocking not just because he seemed to be in the prime of his life, but also because medical science has shown such improvements in reducing deaths from heart disease. Just over a year ago, a team led by researchers at the Centers for Disease Control and Prevention reported that the death rate from heart disease in the USA has dropped by 50% from 1980 to 2000, thanks to improvements in medical treatment and a reduction in risk factors.
…For all those advances, however, medical science still has no definitive way to tell in a given individual when “something’s just around the corner,” says cardiologist Sidney Smith at [University of North Carolina]. The different tests at doctors’ fingertips provide varying amounts of information but not, typically, what doctors and patients most want to know [USA Today]. Stress tests, in which patients run on a treadmill while hooked up to an electrocardiogram, as well as ultrasounds and CT scans all reveal underlying problems, but can’t predict an imminent heart attack.
The best way for nervous people to gauge their risk for a heart attack is still to count up the number of risk factors that apply to them: there are lifestyle factors like diet, exercise, smoking, and stress, as well as the medical conditions diabetes, blood pressure, cholesterol, and obesity. The best way to prevent that heart attack from arriving is to eliminate as many risk factors as possible.
Image: flickr/Patrick J. Lynch