58 is too young to die

Unless you've been living under a rock the last week, you now know that Tim Russert has unexpectedly died at age 58 of a heart attack.

WebMD describes the condition:

That's when the bottom chamber [of the heart] beats at 400-600 times per minute, has no effective blood flow to the brain, you black out, and then, unless it's reversed, you die in three to five or seven minutes or so. This is the rhythm that's treated with an external defibrillator, and had one been available and used, it's certainly possible that he could have been resuscitated.

While Health Blog goes into some more details:

None of that prevented a cholesterol-laden plaque from rupturing while he was doing voiceovers Friday morning for this Sunday’s edition of Meet the Press. The resulting clot, an autopsy indicated, apparently caused his heart to go into ventricular fibrillation which led to cardiac arrest. The autopsy also showed he had an enlarged heart–a manifestation of coronary disease.

This report from the New York Times indicates efforts to revive him through CPR were almost immediate, followed by unsuccessful attempts at defibrillation when an ambulance arrived.

It sounds like he received about the best treatment that can be reasonably expected (CPR then the defibrillation when the ambulance showed up) and presumably had good care leading up to this (some thoughts by others at Kevin, M.D. blog). Although defibrillators are more common than ever, I think the odds of someone recognizing that one is needed within 5 to 7 minutes is pretty low. If some good comes of this, I imagine it will be more defibrillators, more people who at least can potentially recognize when one is required and the limitation of stress tests. Although now every negative stress test might lead to patients demanding cardiac catheterizations and that is not necessarily a good thing.

Photo from Wikimedia Commons.