Doctors - Kile death was preventable

CHICAGO -- The heart condition suspected in the death of St. Louis Cardinals' pitcher Darryl Kile is common and treatable, and should have been suspected given his family history, doctors said Monday.

An autopsy showed the 33-year-old pitcher, found dead Saturday in the team's Chicago hotel, had 80 percent to 90 percent narrowing of two of three main arteries to his heart.

While such extensive blockage in someone so young is unusual, the disease process that leads to it -- atherosclerosis or hardening of the arteries -- is common and can begin as early as childhood, said Dr. Robert Bonow, president of the American Heart Association and a Northwestern University cardiologist.

Atherosclerosis contributes to nearly three-fourths of all U.S. deaths from cardiovascular disease, the nation's leading killer, according to the heart association. Atherosclerosis kills more than 15,000 Americans each year.

While most Americans who die of heart disease are 65 or older, research shows that 80 percent of heart disease deaths in younger people occur during the first attack. In 50 percent of men who die suddenly of heart disease, there were no previous symptoms.

"A very substantial proportion of patients with heart disease never have a clue, and he might have been one of them," said noted cardiologist Dr. Eric Topol, chairman of cardiovascular medicine at the Cleveland Clinic.

Kile's heart showed no sign of scarring or heart attacks, but it was abnormally enlarged, weighing 552 grams, while about 450 grams would be normal, said Cook County's chief medical examiner, Dr. Edmund Donoghue. He said that also can be caused by atherosclerosis.

Donoghue said the artery blockage likely triggered a fatal irregular heartbeat, but that a final finding could take four to six weeks, pending the results of toxicology tests. He gave no indication that drugs or illegal substances were involved.

"The complete results are pending," Donoghue said.

Donoghue also said "possible marijuana" was found in the hotel room, but added, "I want to make it very clear it had nothing to do with his death."

Sgt. Robert Cargie, a spokesman for the Chicago Police Department, said Monday that a substance, "possibly marijuana," was found in Kile's hotel room. He said the substance is being tested.

Donoghue would not comment on whether they were testing for steroid use, and that the autopsy results were consistent with a family history of cardiovascular disease.

Kile's narrowed heart arteries, probably caused by a buildup of fatty plaque deposits, could have been symptomless -- or could have triggered vague signs he might have blamed on the strain of pitching, Topol said.

Kile did complain of shoulder pain and weakness the night before he died -- symptoms that could have been caused by his heart or by his sport.

Kile's father's death from cardiovascular disease in his 40s should have been a red flag signaling that the pitcher was increased risk for suffering the same fate, doctors said.

Cardiovascular disease that shows up at a young age is often hereditary; a gene variation is thought to have caused the heart attack that killed 28-year-old Olympic skater Sergei Grinkov in 1995.

With or without symptoms, patients with a strong family history should get rigorous routine checkups including tests such as cholesterol screenings, blood work-ups, exercise stress tests or heart imaging tests, Topol said.

Such tests probably would have detected Kile's narrowed arteries, which could have been treated with an angioplasty and stent procedure, in which a balloon-tip catheter unclogs the arteries and a tiny mesh coil is inserted to keep them propped open, Topol said.

The heart association estimates that more than a million angioplasties are done each year nationwide.

Kile also may have been a good candidate for daily aspirin and drugs called statins to keep his cholesterol down and his arteries clear, Topol said.

Published reports say Kile had an electrocardiogram during spring training that showed nothing abnormal, but such tests can be normal in someone without previous heart damage, Topol said.

"This is happening every day, but it's just that people are not as visible as Mr. Kile," Topol said. "We have a lot of work to do to get the medical community and the patients to heighten awareness and to get the appropriate diagnostic workup -- and not just once" for people with strong risk factors.

"Clearly we're saying that people with family members who have died early on should be screened at earlier rate than what has been recommended," said Dr. John Lasala, an associate professor of medicine at St. Louis' Washington University and a Barnes-Jewish Hospital heart specialist.

While such screenings are suggested for people in their early 40s, he said, perhaps they should apply to thirtysomethings to be vigilent against "an overt and sometimes a silent killer," Lasala said.

"I think we should put a positive spin on an absolute tragedy -- nobody's immune to heart disease," he said. "Given the right conditions, any of us could develop similar problems. We should be on guard."