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Q
Heart Disease: Outsmarting Heredity?
What do you make of the sudden death of St. Louis Cardinal pitcher Darryl Kile. What screening method can a person at high risk for heart disease but no symptoms do to prevent a sudden heart attack?
A
Answer (Published 1/15/2003)

(Updated 1/25/2005)

Darryl Kile's tragic death in June, 2003, was due to an 80- to 90- percent blockage of the coronary arteries, the arteries that carry blood to the heart. While unusual, Kile's death at the age of 33 isn't unheard of among those with a strong family history of cardiovascular disease. Kile's father died at the age of 44, shortly after suffering a heart attack.

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Kile apparently had no symptoms, although his brother reported that during dinner the night he died, the young pitcher said he felt weak and complained of shoulder pain, both of which could have been symptoms of an impending heart attack. The autopsy showed that Kile had advanced atherosclerosis and an abnormally enlarged heart.

Conditions of this sort can be detected by blood tests (including cholesterol monitoring), cardiac stress tests, and heart imaging tests, all of which are recommended for those with a strong family history of cardiovascular disease. If these tests show that arteries are narrowed, the blood vessels can be unclogged via lifestyle change, medications, and surgical techniques. However, none of the tests are foolproof and in Kile's case they may not have revealed any serious problem. Cardiologists tell me that severe blood vessel narrowing found during an autopsy doesn't always correlate well with results of tests designed to evaluate these changes.

Bottom line: Anyone with a strong family history of cardiovascular disease should be evaluated by a cardiologist and follow his or her advice to reduce heart attack risk.

Andrew Weil, M.D.

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