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Had asthma, high BP, smoker and used pain pills. No drugs detected in blood. What could be the cause of death?

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Practicing since : 1981
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My son ,of 42 yrs. suddenly passed away on 6-06-2012. I've got the coroners report but it's still inconclusive. He was found slumped over a pc. XXXXXXX had asthma, high blood pressure, a smoker, and user of pain pills. Although the report stated there was no significant blood alcohol or drugs detected, some things don't make sense. There was sever pulmonary edema and congestion, acute, bilateral. Cardiomegaly with left ventricular hypertrophy. Mild macrostealosis and sinus hemorrhage, congestive splenomegaly, severe. Segmental erosion of esophagus. left adrenal hemmorage. Brain edema, severe. Moderate obese. I am trying to figure these out in the encyclopedia but some of it doesn't make sense in my sons case. Please advise
Posted Wed, 15 Aug 2012 in Lung and Chest disorders
Answered by Dr. Anil Grover 2 hours later
Please accept my heartfelt condolences on the sudden demise of such a young bright life.
He was 42 and it happened on XXXXXXX 6, 2012. You received autopsy report and which like the blood reports is not making us wiser. Let us analyze.

You mentioned about high blood pressure, he was working on PC that leads me to conclude that he led a stressful life with no time to attend to his teeth job even.

My diagnosis for loss of this young life is Sudden Cardiac Arrest as a result of heart beating out of rhythm arrhythmia-ventricular tachycardia degenerating into ventricular fibrillation. Ischemic (lack of blood supply to heart) could be underlying pathology but there might not be any effect on heart itself due to suddenness of terminal event. For before any pathological changes to take place arrhythmia takes over. No circulation to brain and irreparable damage to brain. He had predisposition to this which is evident in autopsy, left ventricular enlargement with left ventricular hypertrophy is explained by high blood pressure. Preceding his demise for some time he had congestive heart failure which became pulmonary edema (backflow because of poorly pumping heart blood getting collected in spaces between lung tissue and alveoli) with terminal event. Hypoxic brain damage can lead to brain edema (swelling of brain). Congestive splenomegaly, esophageal erosion can occur in congestive heart failure. Therefore, 90% of findings can be explained, what is not explained is he was tolerating the symptoms of congestive heart failure.

Sir, these were stray thoughts. If any point is not clear I will gladly explain in simpler terms. If still not clear you can write to my personal email YYYY@YYYY . It will be act of honor. Take Care.

With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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