[Texas Songwriter]

Here is the thing. The coroner assigning the cause of death as 'Heart Failure' seems improper. In medicine we generally use the term 'heart failure' to connote 'Congestive Heart Failure', NOT coronary artery disease. Now, to be sure, coronary artery disease may lead to enlarging of the ventricles with inadequet pumping ability and it might lead to a chronic condition which in medicine we refer to as heart failure (congestive heart failure). In cardiology coronary artery disease refers to the encroachment of plaque into the lumen of the coronary artery with can lead to a moment in time when there is an infarction (deprivation of oxygen to a segement of the heart muscle) and that can lead to a dysrhythmia and if that dysrhythmia diminishes cardiac output substantially, then there could be a sudden death. Congestive Heart failure is mostly a chronic disease.

Was he on digoxin? Did he have a history of cardiac dysrhythmias or ischemia. Was there evidence of infarction?

The coroner has notl told us very much, or at least this article does not indicate so.

If he died of complications of CAD the death certificate should read, Immediate cause of death-cardiac arrest DUE To Ischemic heart disease DUE TO Myocardial Infarction DUE TO Coronary Occlusive Artery Disease DUE To Cholesterol Plaque of the Anterior Decending Coronary ARtery.

It may well be that the reporter just seized upon the term 'heart failure'.

[americas.best.days...]

Thanks for explaining. I was thinking all this but was too lazy to type it all. (i work in cardiac surgery)

And it didn’t occur to me that it could have been the reporters language, not the coroner/pathologist.

Regardless,RIP Andrew Breitbart, you were terrific in
many ways.

[ntnychik]

My brother died at age 30 of a sudden, massive heart attack. His autopsy report read exactly as you described.

[pieceofthepuzzle]

I agree. If this is being reported properly this is a b.s. cause of death, for all the reasons you point out.

[boop]

Yes. That's exactly what I thought too. Yes people die of "heart failure", but not acutely. People with CHF are staged I to IV, with IV being basically bed bound and on O2. Breitbart was not bed bound by any means. He probably had a massive MI. If he had severe out of control CHF, he would have been swollen with fluid. I just had a patient this week who came in with new onset florid CHF that had been going on for at least a month, but he was put on diuretics and is now doing fine. If I could read the full autopsy report I could tell more.

Misleading reporting IMHO.

[butterdezillion]

Do you know much about how a coroner’s office works?

Also, do you know if a death certificate is on hold until the final cause of death is determined when there is an autopsy?

The two things the coroner’s office has said which relate to the questions you asked are these: the coroner’s office said right away that Breitbart hadn’t seen a doctor for over a year, and now the toxicology report says there were no prescription or illicit drugs in his body. What does that suggest to you regarding his heart history?

In a previous post I asked heartweb some questions about potassium and arsenic poisoning; since you’re a medical person, any insight you might have about those things would be greatly appreciated as well. =)