Friday, June 21, 2013

James Gandolfini's Demise: Heart Attack or Cardiac Arrest

My wife had the pleasure of meeting James Gandolfini earlier this year at a fundraising function and told me that he was just delightful in person, nothing at all like his most famous role as Tony Soprano.  As I'm sure you're all aware by now, the 51yo actor passed away 2 days ago while in Italy.  What's not clear is exactly how/why this happened.  Initial reports stated that he died from a heart attack.  Now some are calling this cardiac arrest.  What's the difference?  And does it really matter?

USA Today put together a nice review of the differences between two conditions.  Most notably, a heart attack (also known as myocardial infarction) is due to blockage of blood flow to the heart, leading to death of cardiac tissue, thus causing chest pain.  Death of heart muscle can also impact the electrical conduction system of the heart, leading to a short circuit, thus stopping the normal beating of the heart, ergo cardiac arrest.  While one can survive a heart attack, if the heart's normal rhythm isn't restarted in time, cardiac arrest most often leads to death.

So what's your chances of a heart attack or cardiac arrest?  Work w/your family doc & review your risk after plugging in a few numbers & facts into the Framingham calculator that gives a 10 year estimate of heart attack risk.  Remember that a 10 year risk >20% is considered the equivalent of already having had a heart attack.  Also, know that this calculator isn't 100% accurate but just the basis for starting a conversation & discussing options for optimizing your health.  Depending upon your age, ethnicity and especially your family history, your risk score may come out higher or lower than it should.  Still, that doesn't mean that you can ignore your blood pressure, cholesterol, sugar & tobacco use.

Take care of yourself, if not for you, then for your family.  51 is an awfully young age at which to pass away. The only consolation I have is that we're a better world for having enjoyed his skills.



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