Collapse of 48 year old male

[GYPZE]

Could WPW be detected post-mortem?

Avid Long distance runner for 6 years.
Slightly enlarged heart ( congenital)
Possible use of fat burners and performance enhancers.
Was on lasix for high blood pressure.
No direct cause of death was reported on autopsy.
Tissue samples and blood work were taken for Toxicology.

Patient had mentioned chest pain, fatigue and leg pain
while running 8 months prior to collapse.  
Enzymes were checked- all within normal limits.
EKG done-??

Any suggestions or clues???
Thank You!!!

[GYPZE]

Jan, He was on some other meds... Unfortunately, I'm
not sure what they were, possibly blood pressure meds.
Besides lasix.
I'm sorry about your friend also.
My friend was 48 yet he still seem so young and it was
so unexpected... I'm sure like your friend also.
Very tragic and painful... these losses are!
And very difficult to comprehend!

[jan]

We just lost a friend, 23 yrs old.  His autopsy said slightly enlarged heart.  He had just gone to the dr that day and according to his gf, the dr did a very weak and incomplete exam.  She tried to get him to get a 2nd opinion.  Anyway, seems this dr decided he had bronchitis and prescribed meds accordingly.  That night he died due to the medication, the parents were told it should've never been prescribed. That info provided thru autopsy which showed no signs of bronchitis, but found the enlarged heart.  

Was your friend on any medication?  

BTW, they were only told about the med and no bronchitis, because they knew examiner, even so he was hesitant to tell.

[GYPZE]

Thank You Very Much!!!  Hankstar!!

All Is helpful!

As most.... I wish there was something to bring him back!!

Respectfully,
GYPZE

[CCF-M.D.-RCJ]

GYPZE,

Thanks for the post.

It might be possible with a meticulous anatomic exam to detect a bypass tract (a cause of WPW) on autopsy, but there are few pathologists who would be sufficiently interested or skilled to allow for this type of exam.  An EKG obtained prior to the death, or at the time of collapse might allow for the diagnosis to be made.

Far and away the most common cause of sudden death in a 48 year-old male in the United States is ventricular tachycardia or fibrillation (VT/VF) from ischemic coronary artery disease.  Given the extra history of possible congenital heart disease, the diagnosis of VT/VF is very, very likely.  Death as the presenting feature of WPW is rare, especially in someone as old as 48 years.

Also, speaking to the pathologist who performed the autopsy may provide clues to the cause of death that were not listed in the report.

Hope that helps.