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Pitcher's Death Shows Heart Disease Strikes All Ages

Problems not just for seniors, but trouble signs hard to detect

TUESDAY, June 25, 2002 (HealthDayNews) -- Clogged arteries, like AARP memberships and senior citizen discounts, are supposed to be reserved for older people. But the death of a 33-year-old professional baseball player of an apparent heart attack is a reminder that even young people need to watch their cardiovascular health, especially if they're at higher risk, doctors said.

"Even though we don't think of heart attacks and strokes as being diseases of the young, they can get you," said Dr. Thomas Bersot, an investigator with the Gladstone Institute of Cardiovascular Disease at the University of California, San Francisco.

Darryl Kile, an All-Star pitcher for the St. Louis Cardinals, was found dead in his Chicago hotel room on Saturday morning. An autopsy revealed that two of his three coronary arteries were 80 percent to 90 percent clogged, and his heart was 25 percent larger than normal.

The final autopsy report hasn't been issued, and more tests are planned that could shed more light on Kile's death.

Cardiologists said it is very unusual for a person in his 30s to die of a heart attack. While arteries begin to become clogged in childhood, it normally takes decades for the process to threaten a person's life, they said. According to the American Heart Association, from 1987 to 1994 only 32,000 men between the ages of 29 and 44 suffered a heart attack each year, compared with 218,000 men between 45 and 64 and 418,000 men 65 and older.

"It takes time to develop the degree of plaque formation and obstruction so you have a catastrophic event like this. It most commonly presents in mid-40s and on up, increasing as age advances," said Dr. John Morse, a cardiologist at Scripps Mercy Hospital in San Diego.

In the past, doctors thought that the arteries of heart attack victims become clogged like backed-up sink pipes, Bersot said. The space for blood flow supposedly shrunk until it was entirely blocked.

But about a decade ago, researchers realized there is plenty of room for blood flow in the arteries of many heart attack victims. The problem is that the growth of plaque on artery walls creates a friendly environment for blood clots, which can form and block the arteries on their own, causing a heart attack, Bersot said.

Four out of five heart attacks happen that way, meaning that the victims usually have no idea they're having any problems until it's too late, he said.

Kile "could have walked on a treadmill the day before or gone out and pitched a no-hitter and felt perfectly fine," he added.

Several cardiologists speculated that Kile must have suffered from several risk factors for heart attack, such as a family history of cardiovascular trouble. In fact, his father died of a stroke at age 44.

Smoking, high blood pressure and high cholesterol are other major risk factors. It's not clear from news reports whether Kile suffered from any of those conditions.

Illegal drug use can exacerbate clogged arteries but can't cause them, cardiologists said.

Unfortunately, doctors don't always detect clogged arteries. "There's no good way to pick it up," Bersot said. Even exercise stress tests and electrocardiograms can miss signs of heart disease, possibly explaining why Kile's physicals didn't turn up signs of problems.

But even though tests aren't perfect, young people should undergo cardiovascular disease screening every five to 10 years, said Dr. Arthur Klatsky, senior consultant to the cardiology department at Kaiser Permanente Medical Center in Oakland, Calif.

Anyone with multiple risk factors should get checked even more often, he added.

What To Do

To learn more about heart attack, heart disease and risk factors, check the Centers for Disease Control and Prevention or the American Heart Association.

SOURCES: Thomas Bersot, M.D., Ph.D., investigator, Gladstone Institute of Cardiovascular Disease, University of California, San Francisco; Arthur Klatsky, M.D., senior consultant, Cardiology Department, Kaiser Permanente Medical Center, Oakland, Calif.; John Morse, M.D., cardiologist, Scripps Mercy Hospital, San Diego
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