Young Death

[stevedut]

Recently my brother died of a heart attack at 32. We have no family history of CAD and he had no personal history of heart disease, his total cholesterol was 190 and HDL 50, His BP 110/70, he jogged 3 miles a day, did not smoke, was vegan. Two years ago he had a routine echo and ecg which was completely normal. Three of our grandparents are still alive. I just can't believe it. I am distraught. How is this even possible? I can't come to terms with it. Please tell me how this could happen? I have been so sad it is hard to come to grips with. My family is also distraught. My parents look so lost and I am concerned about everyone's health. I think everyone is looking for answers on why this happened.

[texas2step]

You asked very good questions.  My Dad died suddenly of an apparent Heart attack at age 35.  I was with him when this happened and was 5 years old.  We always wondered why this happened. WHY?:  His parents lived well into their eighties but my dad's brother met the same fate at age 42.  I say somewhere there was a bad gene that got to Dad and his brother.  My dad's sisters lived also well into their eighties.  It has been 50 years now and we still wonder WHY!

No Marfan syndrome on my side.  Dad was not a big person.

My Sympathy to all involved.

[Cleveland Clinic]

Sorry about your loss.  Unfortunately, sudden cardiac death from heart attack is unpredictable.  In fact, it is the young males with no previous history that seem to be most affected.  He took care of himself and led a good lifestyle, therefore, that's unlikely the root of the problem.  A lot of this stuff is genetic, as we are beginning to learn more and more about it.  He probably is the first case, index case in your family.  You and your parents are healthy and hopefully do not have the same genetic profile.  His kids, if he had any, might be affected.  I think we are also beginning to realize that some nutritional deficiencies may play a role, starvation has been associated with inflammatory states which may lead to premature coronary artery disease.   I know that he was not starving, but being vegan is definitely associated with various vitamin and nutritional deficiencies that may have worsened his condition.  Again, sorry for your loss.  I think you should focus on modifying your conventional risk factors such as cholesterol, blood pressure, smoking and diabetes in order to prevent this from happening.  Again, this is very hard to predict.  Make sure you eat well and exercise daily.    

[tickertock]

First I'd like express my sincere condolences for your lost, nothing is as devastating as when an apparently young healthy person dies suddenly.Sometimes no one really can tell you exactly why it happened even the experts in the field of pathology though they have a good idea. Did you receive an autopsy/postmortem report as to the findings this might go along way as to explaining what happened, sometime bloodwork and tissue samples can take a few  weeks.Once again you have my deepest sympathy, I'm at a lost for words.

[cj163]

Hi Steve,

I am so sorry for your loss, and all the worrying and not knowing that have followed. I wondered if anyone had mentioned the possibility of your brother having high lipoprotein (a) levels - this is a specific type of blood cholesterol which is not always tested for, but is associated with heart attacks occuring at a young age. It is genetic - might be worth you all getting tested?

I hope that is helpful.

[Healthyself2]

Perhaps as the CCF doc mentioned it had something to do with being a vegan.   Lack of the right chemical composition for the heart's electrical conductivity.

I guess that it's not fair that young people walking around, seemingly in perfect health, drop dead and people like me, who had a very unhealthy diet, have advanced 3 vessel CAD, and have been warned that I should aleady be dead without CABG surgery, are still kicking.

I just tell them that I'm not a person who dies.  Some people are, but I am not.  Perhaps, I'm just too dumb to be left out of this world.

[stevedut]

Unfortunately, the examing pathologist has been unable to reach a conclusion on my brothers death.

While the report is extensive, he summarized that:
He ruled out what he said were classic signs of sudden death:
Cardiomyopathy
Inherited Defects for Electrical Abnormalities (from the past EKG and any blood work and pathology)
CAD - all the arteries were clean
Heart Structure - normal, no congenital or other abnormalities

He said the toxicology was negative - because he suspected that my brother may have been on drugs without us knowing - I was certain he would never do something like that especially since he was very responsible.

Finally, he asked if had sugar substitutes, over the counter alternative drugs etc. - aside from some Fish Oil pills and Vitamin capsules there was nothing relevent. There was no mercury so the Fish Oil was also ruled out.

He also sent DNA for some of the latest genetic tests from my brother and all family members and it was all negative.

The pathologist called in a few specialized consults and everything came back negative.

They also checked the brain to see if something was not right.

So, all in all I have come to understand there is no reason they can identify for the death. It is a let down but the family has decided to move on. I believe his time had come and I feel far more spiritual now. I believe he lived a very happy life till the last day and I think we have all managed to gain some strength to carry on and ensure we remain a united and happy family.

I hope this never happens to anyone else but what I've learnt is that life is unpredictable and doctors know very little about the human body - they certainly know a lot about the body but they still don't know so many complex things. I plan to live every day to its fullest and make the most of every moment with friends and family. I wish the same for all of you.

[mas2782]

So sorry to hear about your loss...terribly hard for everyone. I am sure your brother would want you to keep his memory alive and to do whatever you can to help his little boy grow up without his dad.

Please let us know what you find out from the doctor...did they indicate that this was caused by CAD? I agree with other posters that this sounds more like a fatal arrythmia or some sort of undiscovered valvular disease or cardiomyopathy. However with a normal echo it is hard to know.

Again, so sorry for your loss...

[KLB32]

It is highly unlikely he had a true heart attack caused by CAD at his age and with his healthy lifestyle.  I agree that more than likley, it was a fatal arrhythmia.  Long QT syndrome is something that can cause sudden death with absolutely no symptoms.  My college boyfriend died from it at age 22 and to everyone's knowledge, didn't have any complaints prior to his death.  He was very athletic and took good care of himself, too.

My 7 year old cousin died earlier this year of viral myocarditis.  He was mildly ill for a few days then died suddenly.  

So there are a number of things it could have been besides a true hear attack.

I am deeply sorry to hear of your loss.

[healingheart]

I am very sorry for the loss of your brother.  My thoughts and prayers will be with you and your family during this difficult time.  

I am a relatively healthy 38 year old female who had a heart attack last year and was fortunate enough to receive the medical care needed in time.  I still can not get an answer as to why I had the heart attack within 45 days of a CT heart scan and other tests showing no signs of blockage.  I have been under the care of a cardiologist for five years, when diagnosed with a failing aortic valve and enlarged ascending aorta.....with suggestions from doctor's that I may have Marfan's syndrome.  The doctor's say my heart attack was caused by blocked arteries and not from my other heart defects ( I also had a PFO closure a few years back after suffering a stroke caused by the hole in my heart).  I still have to wonder with all the defects, if it may have contributed to the heart attack.  I was first diagnosed with the heart defects at 32.  

I hope the autopsy report gives you and your family the answers you are looking for.

[prjose56]

I am deeply sorry for your loss.  My heart goes out to you and your family and I hope you all pull through.  

I just wanted to comment on the post by Healthyself2.  Atrial fibrillation is generally not fatal.  It's one of the most common types of arrhythmia and many people lead normal lives with it.  Maybe what you meant to say was ventricular fibrillation.  

[stevedut]

He was 5' 10'' and 155 pounds. He was quite athletic. He wasn't on any drugs. They are going to release autopsy results soon. I feel very guilty. My brother was married and had a two year old son. I feel so guilty. I wish I could have done something. I just feel so sad for my nephew. It's such a devastating event.

[Healthyself2]

I'm sorry about your loss.  Unfortunately they tell family that the person had a "Heart Attack" which is not accurate.  It's very unlikely that your brother had a interruption of coronary artery flow which caused his death.  

Most likely it was a fatal arrythmia.  The heart either stopped beating or went into atrial fibrillation.

It sounds like your brother was quite athletic.  There could be many root causes.  Was he on a diuretic?  Some othe drug?  It could have been natural causes?

I always look to drugs as the most likely cause of a coronary event in the absence of a progressive disease.

[tweek1961]

Oops, sorry about that.  I thought it was supposed to be some sort of crude joke.  I was just sick when I read it.  

[DavesMom]

tweek, I also believe that nickpatel was trying to ask about Marfan's syndrome and wasn't attempting to be funny or anything like that. Marfans can, among other things, cause a sudden aortic dissection.

stevedut, I am truly sorry for your loss. Hope you can get some answers as to why this happened.  My best to you and your family.