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 Actor’s
Family Files Wrongful Death Suit
What was thought to originally be Coronary Artery
Disease turned out to be Dissecting Thoracic Aortic
Dissection. The difference in such a diagnosis
on September 11, 2003 may just have been the difference
between an actor remembered and an actor who is
able to live and tell his story. The family of
John Ritter has filed suit claiming just that.
Experts for the defense have argued that even
if the correct diagnosis had been made earlier,
it would not have made a difference in the outcome.
Up Close: Coronary Artery
Disease and Dissecting Thoracic Aortic Dissection
Coronary Artery Disease is the leading cause
of death in Americans today. Sudden cardiac death
is not a clinical diagnosis but rather a descriptor
to identify patients who die within the first
24 hours of diagnosis. Symptoms are usually a
result of a supply and demand imbalance in the
blood supply. Difficulty breathing and fatigue
are the most common symptoms noted. Chest pain
is the most common sign in less than thirty-five
percent. For CAD to be diagnosed and to determine
the affected vessels an EKG, nuclear scan and
angiography are performed. Surgical management
involves angioplasty, where a balloon is inflated
to compress the fat deposits and to open the artery.
Coronary Bypass surgery involves the bypass of
a blockage in one or more of the coronary arteries.
While many may be familiar with the symptom of
chest pressure associated with CAD, dissecting
aortic aneurysm is noted as a tearing pain that
has a sudden onset and can last for hours. The
pain comes quickly and requires no triggers unlike
in CAD where exercise or stress can bring about
the symptoms. Symptoms can include a lower blood
pressure in one arm, difficulty finding pulses,
and paralysis.
An aneurysm is the out-pouching of a vessel wall.
They can balloon out or encircle the vessel. Successful
treatment is dependent upon quick and efficient
diagnosis. A dissecting aneurysm is a surgical
emergency because the blood separates the vessel
layers, and a larger portion of the vessel may
be affected. Symptoms are caused by an increased
pressure on the surrounding structures. Once the
vessel wall loses it continuity a rupture can
occur.
These patients experience severe abdomen and
back pain when the aneurysm is leaking. Extreme
pain indicates a catastrophic event. The definitive
treatment is surgery. If the patient has a cardiac
arrest prior to surgery and they are unconscious,
time may be too little to wait for the OR. The
chest will then need to be opened in the ER in
hopes of having time to clamp off the aorta.
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