Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: Pseudoscience-is-malarkey on 29/01/2015 11:13:20
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My father had a semi-serious cancer that metastasized to his pancreas (he had a melanoma tumor removed from his chest fifteen years ago). He went through several chemo treatments, and had a pancreaticoduodenectomy scheduled. On top of that he had heart problems (He had a coronary stent and a pacemaker). On June 12th 2014 his cardiologist scheduled a June 16 procedure to replace his deteriorating stent. I arrived at his house that morning to drive him to his surgery. But no surgery was to happen that day, or any day for that matter. He was dead. I found him dead in his guest bathroom (he was spending all his time in the family room and the guest bathroom was a shorter distance). He had been dead for at least twelve hours. Despite the clear presence of suggillation on his face, the 911 operator instructed me to try to resuscitate him. Absurd, but I complied. I reasoned that I had no right to question someone that probably instructs people on resuscitation every day. The ambulance technicians arrived and told me what I already knew. He was 66.
I am curious if there is a correlation between chemotherapy and sudden cardiac death. When I found my dad there was blood on the bathroom floor from the trauma of hitting his head on the sink during his collapse. His pants were unzipped. Is this a typical scenario in cardiac death? Any doctors or nurses on this forum? If yes, I ask for your inference. It was obviously sudden? Dead before he got a chance to realize something was wrong? It is said that before the attack victims usually feel generally unwell, with nausea, dizziness, and vomiting. If that is the case I wonder why he didn't call an ambulance. Or me, or whatever.
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I'm very sorry to hear your story, and I hope that you are coping okay in the aftermath.
It's quite frequent for people to suffer cardiac events precipitated by sudden exertion, which can include the effort of making one's way to the toilet, or even the physical act of using the lavatory. Both can increase the demand on the heart, increasing the risk of disclosing an underlying abnormal electrical rhythm; such a rhythm problem may be a consequence of ischaemia (poor blood and oxygen delivery to the heart) caused by coronary artery disease, or prior injury to the heart secondary to an infarct (heart attack), which may even occur "silently" beforehand. Patients who also have diabetes, for instance, can be found to have had previous asymptomatic or undiagnosed heart attacks, probably owing to nerve damage associated with their diabetes.
It's likely that one or more of these factors could have occurred in your father, precipitating a fatal arrhythmia (heart rhythm disturbance) that led to his collapse.
Having seen this happen to a number of patients over my career, I can reassure you that people who collapse suddenly like this do not suffer and are not aware of what is happening to them. The sudden loss of cardiac output causes near immediate loss of consciousness, so it's very unlikely that your father would not have been in pain or discomfort when he died.
Again, my condolences and sympathy for your loss.
Chris
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... His pants were unzipped. Is this a typical scenario in cardiac death?
Cardio-vascular events at defecation
... The Valsalva Maneuver (http://en.wikipedia.org/wiki/Valsalva_Maneuver) adversely affecting the cardio-vascular system is the causative factor of defecation syncope (http://en.wikipedia.org/wiki/Syncope_%28medicine%29) and death. The cardio-vascular system of a healthy man withstands the intensive and repeated straining at defecation, while the compromised cardio-vascular system may fail resulting in syncope or even death.
http://www.ncbi.nlm.nih.gov/pubmed/2398836