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Tim Russert: A Tragedy - Sudden Death But Was It Unannounced?

By R.C. Goode

It is difficult to understand the loss of an adult in the most productive phase of life. In general, it is believed that living to 85 years of age is an expectation, especially if following the predictors set forth by George Valliant, Director of the Harvard Longitudinal Study, and author of AGING WELL. Despite all the knowledge of causative factors for heart disease, Tim Russert, a highly respected senior news commentator, died of a heart attack at age 58 years, in June 2008.

In Mr. Russert's case, there were no untoward signs of heart disease. He was taking statins to control serum cholesterol and other fats, the blood pressure was under control, and he was exercising regularly. He had performed an exercise-stress test which can indicate if the blood vessels of the heart were partially blocked. Exercise capacity would likely have been reduced if the vessels were blocked. The electrocardiograph would have signalled that the heart was experiencing undue stress. However, in Mr. Russert's case, these indicators were not present, although a profile of the blood showed high triglycerides (a kind of fat in the blood) and the HDL (high density lipoprotein) was too low compared to the LDL (low density lipoprotein) which was comparatively too high.

Fifty percent of heart attack deaths occur without warning, while one is going about normal routines. Some occur as a consequence of severe exertion. However, current evidence suggests that habitual vigorous activity (See "Talk Test and Breath Sound Check") reduces the risk of a coronary attack. The autopsy report of Tim Russert cited a blockage of the blood vessels supplying the heart muscle and a blockage in a major heart artery triggered an irregular heart rate. This change in rate stopped the heart from pumping blood. An angiogram would have likely revealed the severity of the blockages in Mr. Russert's heart. A by-pass operation may have reduced the likelihood of the sudden death. As there were no signs of undue stress during the exercise test and the other risk factors were considered acceptable, the medical staff decided not to perform the angiogram. Angiograms do carry a slight risk of complications; although less than 0.1% are considered serious.

The one predictor that was not within the normal range for Mr. Russert was the waistline measurement, which was above 40 inches. The American Medical Association indicates that for men, a waistline greater than 40 inches is a risk factor for heart disease (in women, the measure is 35 inches). Recently, Japan "ordered" citizens to have a waist measurement made at the annual medical check-up. Those who need to bring the waistline measurement down are asked to go on a program. The measurement at the waistline (bellybutton) should not be greater than the widest part of the hip measurement (buttocks). Tim Russert's physician is reported to have said that if there is one number that is a predictor of mortality, it is the waist circumference measurement. The prime reasons for heart disease are recognizable predictors, such as smoking, elevated blood fats, high blood pressure, sedentary lifestyle and an enlarged waistline. Recognition of these predictors is a matter of education, during the school years, as this information enables an individual to establish habits.

Written by R.C. Goode

(Click to read “Talk Test and Breath Sound Check”)

The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advise. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.

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