Friday, June 30, 2006

Randy Walker: Another Victim of Sudden Death

Sadly, Randy Walker, Northwestern's exceptional football coach, died last night of sudden cardiac death. We are all confused, surprised, and saddened beyond words when such things happen. It is moments like this that all cardiologists and cardiac electrophysiologists second-guess ourselves to be sure we do the right thing for our patients. In evaluating patients with cardiac disease, we look heavily to the person's cardiac ejection fraction (the percentage of blood pumped from the cardiac chamber with each heart beat) to guide us regarding recommendations of when to implant an automatic defibrillator. (I have posted extensively on ejection fraction before). Most of these data regarding when to implant a defibrillator come from patients with blockages of their coronary arteries ("atherosclerosis"). Little data are available to guide us in cases of "myocarditis," like it is reported that Mr. Walker had. Whether he had a heart attack, or primary cardiac rhythm disturbance that lead to his death, we may never really know.

But what we do know, is that the lower the ejection fraction, the more likely someone will die of sudden cardaic death. We should use this unfortunate event to always remember this and be proactive at recommending these life-saving devices to our patients, even with all the negative press out there lately regarding device recalls and all. These recalls represent a tiny fraction of patients that must have their device replaced. Many more patients' lives are saved each and every day from these devices.

And another thing, Randy Walker's life was lost yesterday, but another patient of mine's life was saved by the presence of an automatic external defibrillator (AED) in his workplace. He collapsed suddenly, but alert friends came to his aid, slapped on the AED pads, and with one shock, his heart rhythm was restored and he was awake, alert, and fine later that day.

So if you or a family member have a history of heart disease of ANY kind, ask your doctor what your "EF" (ejection fraction) is. Think about getting an AED for your workplace. It could save your life, a friend's life or a loved one's life.


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