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    Tim Russert Dies of a Heart Attack

    Russert, 58, Died at Work, Says NBC News

    Cardiologist's View continued...

    Now, ventricular fibrillation may be caused by a heart attack; it doesn't have to be. The likely scenario in a 58-year-old, slightly obese male is a coronary thrombosis -- an obstruction of a coronary artery -- that triggers the ventricular fibrillation and causes the sudden death.

    It's common to use the term heart attack for any heart death. Is that correct in this case?

    Exactly. That's what the press usually says -- he died of a "massive heart attack" and that massive heart attack is actually ventricular fibrillation. That's the cause of the sudden death, and it's important to distinguish this, because that's reversible with a shock.

    The only other thing that NBC is reporting at this point is that he had recently returned from Italy.

    It's likely unrelated. I've no idea how recently and whether [during] that eight-hour plane ride he sat still and developed blood clots in his legs and then had a massive pulmonary embolism [in which a blood clot travels to the lungs] once he got off the plane and was back at work. That's a much less likely scenario, but it does bring in the fact that he was recently in Italy.

    What would you want people to know about lead-up symptoms or anything else people may need to be aware of or watching for?

    Unfortunately -- and in a 58-year old male is typical -- sudden death may be the first manifestation of underlying heart disease. You die and that's the first manifestation of underlying heart disease.

    Now, I have no idea of his medical history -- whether he had risk factors such as elevated cholesterol, diabetes, high blood pressure, whether he was a smoker off TV, and so on. But all of these risk factors would be very important. Was he sedentary, how stressful was his job, and so on. [Editor's note: NBC now reports that Russert had earlier been diagnosed with heart disease, but it was well controlled with medication and exercise, and he had performed well on a stress test in late April.

    Is there anything else you would want to add?

    I'd like to stress the fact that we need to have external defibrillators as common as fire extinguishers, so that when an event like this happens, a defibrillator is available and at least you can make an attempt to possibly save a life.

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