49'er

[Mkyle]

You would think that every NFL physical would test for heart disease!! Don't they? What a shame...


Coroner says Herrion died of heart disease
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Associated Press
Posted: 1 hour ago



DENVER (AP) - San Francisco 49ers lineman Thomas Herrion died from heart disease when he collapsed after a preseason game in Denver on Aug. 20, the Denver County coroner said Tuesday.

Herrion had ischemic heart disease, with significant blockage in his right coronary artery that caused the death of heart muscle, the city health department said in a news release. Herrion's heart was slightly enlarged.
Drug screens on Herrion's blood and urine found only atrophine, a drug administered when medical personnel tried to revive him.

Herrion, 23, was pronounced dead early on the morning of Aug. 21. The 6-foot-3, 310-pound guard was on the field for San Francisco's 14-play, 91-yard drive that ended with a touchdown with 2 seconds left.

Players had finished listening to coach Mike Nolan address them in a postgame meeting when Herrion collapsed. Medics administered CPR on him and took him to an ambulance that rushed him to a nearby hospital.

About three hours later, 49ers spokesman Aaron Salkin confirmed that Herrion had been pronounced dead.

 

[MichaelWinicki]

You would think that every NFL physical would test for heart disease!! Don't they? What a shame...


Coroner says Herrion died of heart disease
Story Tools: Print Email
Associated Press
Posted: 1 hour ago



DENVER (AP) - San Francisco 49ers lineman Thomas Herrion died from heart disease when he collapsed after a preseason game in Denver on Aug. 20, the Denver County coroner said Tuesday.

Herrion had ischemic heart disease, with significant blockage in his right coronary artery that caused the death of heart muscle, the city health department said in a news release. Herrion's heart was slightly enlarged.
Drug screens on Herrion's blood and urine found only atrophine, a drug administered when medical personnel tried to revive him.

Herrion, 23, was pronounced dead early on the morning of Aug. 21. The 6-foot-3, 310-pound guard was on the field for San Francisco's 14-play, 91-yard drive that ended with a touchdown with 2 seconds left.

Players had finished listening to coach Mike Nolan address them in a postgame meeting when Herrion collapsed. Medics administered CPR on him and took him to an ambulance that rushed him to a nearby hospital.

About three hours later, 49ers spokesman Aaron Salkin confirmed that Herrion had been pronounced dead.

There are many things about the heart you can't test for.

 

[joseephuss]

I was listening to ESPN a couple of days after Herrion's death. I think it was Mark Schlreth that was saying that every player in college and theNFL should get mandatory EKGs. Right now, very few guys get them and they can be very helpful in finding out things about the heart.

There may be a lot of things that can't be tested about he heart. At least without extensive testing and monitoring. But there a bunch of things that can be tested for and are not. And these tests are relatively inexpensive.

 

[Mkyle]

There are many things about the heart you can't test for.

But, Michael, you can test for a blocked artery...not to prolong this, or this post can be removed to somewhere else, but, if you get a yearly physical, (I do) they always stress test the heart, and check blood samples and other stuff to find that out.

Where is Jobberone?

Mkyle

(OK, back to vacation, before the warden finds out I'm not locked up)

 

[NMfan]

How in the world at age 23 can you have significant blockage in a main artery? His cholesterol levels must have been off the chart since he was 10 years old. There must be more to this story.

 

[Eskimo]

A couple of things I would like to point out. To some extent we all suffer from coronary artery disease. Virtually every adult will show evidence of plaques in their coronary arteries.

Herrion most likely had a sudden cardiac death or a fatal heart arrhythmia provoked by a blockage in a coronary artery.

The heart's main blood supply comes off as one of the first branches off the aorta as left main coronary artery. This subsequently divides into three major arteries - the right coronary artery, the left anterior descending artery and the left cicumflex artery. These arteries branch out and supply the blood flow to the heart muscle.

Herrion's disease was in the right coronary artery. The shameful part is that if you survive this type of heart disease (which has a very high survival rate) your outcome is very good because this artery provides very little of the critical blood supply to the left ventricle which is the main powerhouse of the heart and responsible for pumping the oxygenated blood of the heart to the whole body.

It is extremely unusual to have developed significant ischemic heart disease at such a young age. Most MIs at that age are due to drug use and coronary vasospasm (get a functional blockage in blood flow to the heart from muscles in the artery wall going into spasm). It sounds as though this is not the case with Herrion. This does occur sometimes in the setting of familial hypercholestolemia which is a disease of cholesterol metabolism - I don't know if this is the case here. There is often a genetic component to early ishchemic heart disease that is poorly understood but it is still exceedingly ususual to present at such a young age. He was a large fellow so steroids could have played role but I don't know the risks are at this age.

With regards to EKGs - they are much better at detecting existing structural heart disease than they are at detecting narrowing of the arteries. The time they may be useful is for individuals who have hypertrophic cardiomyopathy such as Hank Gathers - the college basketball player who died in the early 90s - these guys have a high rate of sudden cardiac death when put through extreme physical exertion (and even if not - many of them now undergo placement of internal heart defibrillators now). The other group that is useful to identify is those with a defect in electrical channels of the heart - they are known as long-QT syndrome.

In terms of symptomatic cardiac disease, narrowing of the vessels is usually about 75% before someone develops significant symptoms.

There is a very high chance that even a stress ECG would not pick up right coronary artery disease.

I suspect this is a case of colossal genetic misfortune.

I do not know the wisdom of universal screening programs in these populations. If the incidence of disease is very low it can lead to lots of false positive tests that can lead to more invasive tests which have a certain rate of complication - I have treated a few patients who have had strokes or gone into kidney failure after an angiogram.

This sort of question is best left to epidemiologists to cruch the statistics. I suspect a screening program for ischemic heart disease would be of minimal benefit in detecting cardiac disease in this population.

 

[Mkyle]

Thanks Eskimo...although I don't understand a lot of what you said, I did get the jist of what you said...

The question becomes, do you think the NFL (or any sport for that matter) could or should do a better physical on their potential players, or do you think this is something that no matter how much they test, they will not find the cause?

Mkyle

(back to vacation....)

 

[Eskimo]

Thanks Eskimo...although I don't understand a lot of what you said, I did get the jist of what you said...

The question becomes, do you think the NFL (or any sport for that matter) could or should do a better physical on their potential players, or do you think this is something that no matter how much they test, they will not find the cause?

Mkyle

(back to vacation....)

I think a simple ECG would be useful to pick up the conditions I was talking about.

A rigorous preseason physical exam and conditioning tests would suffice, IMO - this is most likely what is the current practice.

The one thing I always try to keep in the back of my mind is that everyone is going to die. The question about the usefulness of screening programs for various conditions is always a hot topic in medicine - debates been going back and forth for years on things like colonoscopies for colorectal cancer, PSA for prostate cancer and screening mammography for breast cancer amongst others.

Generally screening programs are thought to be useful when the disease has a high prevalence in the target population (breast cancer in women over age 45 - lifetime risk 10%), there is a good non-invasive and inexpensive test that can detect the disease at an early stage (i.e. mammography but this is debateable) and that when a disease is detected at an early stage there are effective treatments (i.e. lumpectomy + radiotherapy + chemotherapy) to prevent progression to clinical disease or prevent some clinical endpont (i.e. death from breast cancer). Probably the most effective screening program invented in medicine was for cervical cancer with Pap smears. At the turn of the century this was the number one cancer killer of women and now should be a thing of the past (it is if you get your yearly Pap).

My guess is that given the rate of ischemic heart disease in 20-35 year old male competitive football players who are asymptomatic and performing at a very high level, a screening program with stress ECGs is unlikely to be effective at preventing major cardiovascular morbidity.

It is a very sad statement but that is a limitation of modern medicine - we don't have a very good understanding of what ultimately initiates coronary artery disease and we don't really have very effective preventitive strategies in place.

My best advice to the general population is see your doctor regularly, eat sensibly, don't smoke, keep your weight under reasonable control, exercise regularly, floss your teeth and starting around age 35 get your blood cholesterol and sugar checked regularly. Then just pray for the best.

One of the tragic things in medicine is when in such a situation the family asks you why and you really don't have much to offer them except a shoulder to cry on.

 

[Mkyle]

Thanks Eskimo...also, I apologize to the forum for keeping this dicussion alive, but, it is very, very important information that Eskimo is giving us here! The forum wardens can move it to somewhere else that we can't find, if they wish...

However, it is so important to understand...don't take it for granted!

"The one thing I always try to keep in the back of my mind is that everyone is going to die."

How true...but, I guess we have it coming!

Thank you, Sir...I for one am very interested in what you told us...and I hope everyone else realizes...take care of yourself....

love
Mkyle

(back to vacation...the trustees are gonna bring my meal sometime soon)! :>0

Pay heed everyone...this is good advice....

 

[Eskimo]

Thanks Eskimo...also, I apologize to the forum for keeping this dicussion alive, but, it is very, very important information that Eskimo is giving us here! The forum wardens can move it to somewhere else that we can't find, if they wish...

However, it is so important to understand...don't take it for granted!

"The one thing I always try to keep in the back of my mind is that everyone is going to die."

How true...but, I guess we have it coming!

Thank you, Sir...I for one am very interested in what you told us...and I hope everyone else realizes...take care of yourself....

love
Mkyle

(back to vacation...the trustees are gonna bring my meal sometime soon)! :>0

Pay heed everyone...this is good advice....

Always try to play the delicate balance between living in the present and planning for the future. Going too far either way will lead to unhappy consequences.