心Disease, Lessons Learned From Pitcher's Early Death

DOCTOR'S VIEW ARCHIVE

Medical Author: Daniel Lee Kulick M.D.
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

The sudden death of baseball pitcher Darrel Kile at age 31 has prompted numerous questions about how such an event might be prevented. While Mr. Kile's full medical history is not publicly available, it is known that his family history was remarkable for the presence of冠状动脉疾病(CAD) at an early age; his father passed away due to aheart attackin his early 40's.

The presence of a family history of CAD before the age of 50 is a particularly ominous "red flag," that should be taken very seriously. Even in the absence of other known "risk factors" for CAD (cigarette smoking, lowHDLand/or a highLDL cholesterol,hypertensionordiabetes), the presence of such a family history should alert one to the need for optimal lifestyle choices and the need for early screening for the presence of underlying CAD which has not yet resulted in symptoms. For example, in the setting of a genetic predisposition to the early development of CAD, a "normal"cholesterolprofile might be made even more favorable by dietary changes or medication.

Numerous screening tests are available for the detection of CAD in young people with a family history ofheart disease. Conventionalexercisestresstests, even without adjunctive nuclear imaging, are designed to identify blockages of 50% or greater in the coronary arteries. Newer "calcium scans" of theheartmay detect even earlier blockages, alerting one to the early presence of CAD, before a cardiac event likemyocardial infarction(heart attack) or sudden death occurs. If the disease is detected early, lifestyle modification withdiet,exercise,smoking cessation, and possibly drug therapy may forestall the development of more severe disease. The early detection of severe coronary artery blockages, before cardiac events occur, may result in potentially life-saving revascularization procedures, such as coronary artery stenting orangioplasty, orcoronary artery bypasssurgery.

All people with a family history of CAD at an early age should ask their doctors about which screening test is most appropriate for them. Early detection of CAD may allow thepreventionofheart attacksand sudden death, enabling tragedies like that of Darrel Kile to be a much more infrequent occurrence.

For additional information, please visit the心Attack PreventionCenter.